Factors Associated with Failure to Receive Antenatal Care

A community-based case-control study was conducted to characterize pregnant women who did not receive antenatal care. 1,274 deliveries over a 1-year period were documented by weekly visits to 120 study villages. Eighty five women (6.7%) received no antenatal care. By univariate analysis, factors found to be associated with failure to receive antenatal care included maternal age, paternal age, paternal education, home ownership, availability of toilet, annual income, housing condition, gravidity, parity, history of infant death and birth intervals. After logistic regression analysis, only paternal age, paternal education, parity and lack of toilet in the household were found to be associated with failure to receive antenatal care.     

Comparison of three antigen preparations to detect Trichinellosis in live swine using IgG-ELISA

A swine infected with Trichinella spiralis is a source of transmission to human through consumption of raw or improperly cooked pork. Detection of larvae is suitable for carcasses, so that pigs in households or farms can be examined serologically for trichinellosis. This study compared antigens, crude (CAg), excretory-secretory (ESAg) and surface (SAg), for their potential use in IgG-ELISA. Serum samples were collected from 5 experimentally infected swine with T. spiralis (pTs), 147 positive cases of 9 other parasitic infections, 12 mixed infections of other parasites, and 35 normal controls. At the same 100% sensitivity, specificity of tests was in a range of 98-77%. ESAg was the best source of antigen with specificity of 98.3% at cut-off value of 0.439. False positives included coccidiasis (1/86) and mixed infections (2/39). For CAg, trichuriasis (2/11), coccidiasis (5/86), and mixed infections (8/39) gave cross-reactions and some of these samples had OD values far above cut-off value of 0.332. Cross-reactions of SAg were Oesophagostomum spp-like GI-nematode infection (1/1), unidentified GI-nematode infections (2/3), trichuriasis (5/11), coccidiasis (29/86) and mixed infections (4/39). Thus, ESAg has the highest potential in serodiagnosis, with antibody to T. spiralis in pigs being detected at the earliest 16 day post-infection. However, crude antigen demonstrated a good specificity at 91.8%, and this antigen has a potential to be used as a detection of choice for swine trichinellosis, but the antigen preparation must be improved for higher specificity.     

Pharmacokinetic interactions between ciprofloxacin and itraconazole in healthy male volunteers

Objective. To investigate the pharmacokinetic interaction between ciprofloxacin and itraconazole in healthy male volunteers. Methods. Ten healthy male volunteers were assigned into a 2‐sequence, 3‐period pharmacokinetic interaction study. In phase 1, all subjects were randomly assigned to receive 500 mg of ciprofloxacin alone and 200 mg of itraconazole alone twice daily for 7 days with a 14 day wash‐out period in a crossover design. Phase 2 was performed 14 days after finishing phase 1, all subjects received 500 mg of ciprofloxacin in combination with 200 mg of itraconazole twice daily for 7 days. Ciprofloxacin and itraconazole pharmacokinetics were studied and adverse effects noted. Results. Ciprofloxacin significantly increased the C_max and AUC_{0 ? ∞} of itraconazole by 53.13% and 82.46%, respectively. The half‐life and CL of itraconazole were not changed significantly. The combination of itraconazole and ciprofloxacin could therefore result in an increase in adverse drug reactions. Conversely, itraconazole had no significant effect on the pharmacokinetics of ciprofloxacin. Conclusion. Ciprofloxacin decreases the metabolism of itraconazole, most likely through inhibition of CYP3A4. The dosage of itraconazole should be reduced and its therapeutic outcome should be monitored closely when these two agents are concomitantly administered. Copyright © 2011 John Wiley & Sons, Ltd.     

Hookworm infections of schoolchildren in southern Thailand

A study of hookworm infections of schoolchildren was conducted in Nakhon Si Thammarat Province, southern Thailand. Of the 2,940 hookworms that were recovered from the children, almost all (99.9%), were Necator americanus, only three (0.1%) were identified as Ancylostoma duodenale, and all were female worms. An estimation of the worm burden of and the worm expulsion from the schoolchildren indicated there were 17 cases of light intensity hookworm infection. Fifteen cases (88.2%) expelled worms in numbers that corresponded with the worm burden that was estimated from the number of eggs per gram of feces. Two cases (11.8%) expelled more worms than predicted. In 16 moderate intensity cases, five (31.3%) expelled worms in a quantity that corresponding with the estimated worm burden. Eleven cases (68.7%) expelled fewer worms than predicted. All cases of heavy intensity infection expelled fewer worms than predicted.     

Risk factors of helminthiases among schoolchildren in southern Thailand

School-age children are particularly at risk of soil-transmitted helminthiasis (STH), which affects their growth and development. Hence, school-based helminthiasis control has been discussed and conducted as one of cost-effective ways in developing countries. A parasite control program is to be planned and conducted in an evidence based way as one of practical medical fields. However, a prevalence is likely to be influenced by various factors such as local environment and residents' behavior and so on. As few reports mentioning the relation of the prevalence and children's behavior and practice have been published, we conducted a survey to investigate such relation by asking children directly. Two hundred and eighty pupils in grade 3 to grade 5 were enrolled, who were in the two schools in Nakhon Si Thammarat Province, southern Thailand. A cross-sectional study was conducted in February and in November 2001, on the relationship between helminthiasis and children's knowledge and practice by using Kato-Katz method and a questionnaire, respectively. Hookworm (Hw) was the most predominant helminth followed by Trichuris. Boys had more intensive Hw infection than girls (p = 0.022), and wore shoes less frequently than girls (p < 0.001). The pupils who nearly acquired Hw infection after the first stool examination had lower levels of the knowledge of STH comparing to those who did not (p = 0.011). This study suggests that a prior survey can identify unique local factors as a part of diagnostic process, the results of which are useful for teachers to understand some points of health education at schools and can be applied as indicators for monitoring and evaluation.     

Influenza viruses circulating in Thailand in 2004 and 2005

Determining the local circulating strain of influenza is essential to prevent and control epidemics. In the years 2004 and 2005, the National Influenza Center of Thailand received 3,854 and 3,834 specimens, respectively, from patients throughout the country, including submissions from 4 established influenza surveillance sentinel sites. In 2004, of 539 influenza-positive specimens, 461 were positive for influenza A and 78 were positive for influenza B by isolation. Influenza A subtyping revealed that 249, 197, and 15 isolates were H1N1, H3N2, and H5N1, respectively. In 2005, of 748 influenza-positive specimens, 492 were influenza A and the remaining 256 were influenza B. The results of influenza A subtyping indicated that 55, 437, and 5 isolates were H1N1, H3N2, and H5N1. All isolated strains of subtype H1N1 were A/New Caledonia/20/99-like. The isolated strains of H3N2 were A/Fujian/411/2002-like in the first half of the year 2004, while those in the latter half of 2004 gradually drifted to a mixture of A/Wellington/1/2004-like, A/California/7/2004-like, and A/Wisconsin/67/2005-like, and this mixture continued through the end of 2005. The influenza B strains were B/Sichuan/379/99-like, B/Hong Kong/330/2001-like, B/Shanghai/361/2002-like and B/Malaysia/2506/2004-like. The strains circulating in the years 2004 and 2005 were antigenically similar to the vaccine formulas recommended in the same period by WHO. Our results underscore that local influenza surveillance plays an important role in responding to epidemics and potential pandemics.     

Isolation and identification of influenza virus strains circulating in Thailand in 2001

Local influenza surveillance plays an important role in preparing for, and responding to, epidemics and pandemics. Between January and December 2001, the National Institute of Health of Thailand collected a total of 711 throat swab specimens from outpatients affected with acute respiratory symptoms from several centers throughout Thailand, of which 374 were virus-positive. Of these, 338 (90.4%) were positive for influenza virus by immunofluorescence testing. By hemagglutination-inhibition (HI) testing, 155 of the type A viruses were found to be subtype H1N1 strains closely related to A/New Caledonia/20/99, and 70 were subtype H3N2 A/Moscow/ 10/99-like viruses. For type B, the isolates were antigenically B/Sichuan/379/9-like by HI, although a number of the strains could be shown to be more closely related to earlier influenza B strains by genetic analysis. The strains circulating in Thailand were antigenically similar to strains isolated worldwide during the same period and to strains recommended by the WHO for inclusion in the vaccines for use in 2001-2002.