Socio-demographic, agricultural, and personal protective factors in relation to health literacy among farmers from all regions of Thailand.

Introduction: Farmers are vulnerable to adverse health effects from pesticide exposure due to their health literacy (HL). Therefore, this study aims to investigate HL among farmers in four main regions of Thailand, investigating socio-demographics, agricultural, and personal protective factors to their HL. Methods: This cross-sectional design study was conducted on 4,035 farmers from January to July 2023. The European Health Literacy Survey Questionnaire-47 items were used to measure HL. Results: Thai farmers had a mean HL score of 34.7 ± 8.7, and the farmers in the North region of Thailand had the highest frequency of limited HL (75.8%). Socio-demographic factors that were associated with HL included gender, region of living, marital status, education level, co-morbidity, and number of family members. Agricultural factors associated with HL included planting status, working hours on farm, spraying pesticides, harvesting crops, pesticide use of >1 type, access information from government officers, access information from posters/brochures, information from online multimedia, and access information from neighbors. Personal protective factors that were associated with HL included wearing a hat, goggles, a rubber apron, and a long-sleeved shirt. Discussion: Our study recommends that strategies and interventions to enhance the HL of farmers should be focused on the target populations, which include men, widows, or divorced, those with low levels of education, those who have co-morbidities, and those who applied pesticides of more than 1 type and improper personal protective equipment (PPE) use. The primary emphasis needs to be on the North region of Thailand, making that the target area to improve health equity in Thailand. These efforts would enhance the HL of farmers and sustainably improve pesticide safety behavior. Additionally, there is an urgent need for supportive measures aimed at altering on-farm practices and promoting education on alternative pest management strategies, particularly non-chemical crop protection, to ensure sustainable agriculture.

Is low carotid bifurcation determined by vertebral level always convenient for surgical approach?

Although high-level carotid bifurcation (HCB) could lead to notable surgical difficulty, the definitive reference point for HCB is unclear. HCB is typically characterized as carotid bifurcation (CB) located higher than the level of the third cervical vertebra (C), however, a major obstacle regarding carotid artery surgical exposure is angle of the mandible (AM). The objective of this study was to investigate CB level, define HCB in relation to AM and vertebral levels, and measure the vertical distance from HCB to ipsilateral AM. Moreover, the percentage of surgically challenged CBs, misclassified as low CBs (LCB) based on vertebral level, was investigated. Patients who underwent neck computed tomography angiography were retrospectively studied. HCBs were classified into two categories: CBs above the C3 and either at or above the ipsilateral AM. Of 172 CBs (86 patients; 57 men, 29 women), CB was mostly found at C3 (44.19%), whereas AM was commonly located at C2 (51.16%). Based on vertebral level and AM, HCBs were detected in 10.47% and 20.35% of CBs, respectively. The association of HCBs determined by either C3 or AM between both sides in each individual was nonsignificant (p>0.05), but HCBs determined by C3 level were predominant in women (OR = 3.58, 95%CI = 1.31-9.80). Considering both C3 and AM, there was 8.72% of HCBs. The remaining 91.28% was classified as LCBs, including 11.63% of CBs located at both C3 and AM which were actually classified as HCBs if determined by AM. In cases of CBs above AM level, the mean vertical distance was as high as 6.56 ±2.41mm.

Acute health symptoms related to perception and practice of pesticides use among farmers from all regions of Thailand.

Introduction: Occupational exposure to pesticides may cause acute health effects for farmers and agricultural workers. Therefore, this study aims to investigate the prevalence of poisoning symptoms related pesticide exposure among farmers from all regions of Thailand, as well as factors linked to poisoning symptoms of neurological and neuromuscular systems, the respiratory system, and eye and skin disorders. Methods: A cross sectional study was conducted in 4,035 farmers who lived in four regions of Thailand. The samples were chosen using stratified random sampling, with 746 for the Central region, 2,065 for the North-East, 586 for the North, and 638 for the South. Results: The results found that the highest prevalence of poisoning symptoms was found in association with neurological and neuromuscular systems (75%), followed by the respiratory system (60.4%), the eyes (41.2%), and skin (14.8%). The most prevalent symptoms were muscle pain (49%) for neurological and neuromuscular symptoms, burning nose (37.6%) for respiratory symptoms, itchy eyes (26.3%) for eye symptoms, and rashes (14.4%) for skin symptoms. The remarkable findings were that types of pesticide use, task on the farm, types of pesticide sprayers, and perception are the crucial factors affecting all poisoning symptoms. Discussion: The findings are also beneficial to the Thai government and other relevant organizations for launching measures, campaigns, or interventions to lower modifiable risk factors, resulting in reducing health risks associated with pesticide exposure.

Changes in agricultural context and mental health of farmers in different regions of Thailand during the fifth wave of the COVID-19 pandemic.

BACKGROUND: Thailand's agricultural sector is crucial to the country's development and economy. The COVID-19 pandemic caused negative effects on the agricultural context and the mental health of Thai farmers. This study aimed to compare changes in the agricultural context and mental health among farmers in different regions of Thailand during the fifth wave of the COVID-19 pandemic. We also investigated the determinants associated with the mental health of farmers. METHODS: This cross-sectional study was carried out from December 2021 to January 2022 in Thailand, with 1,676 Thai farmers interviewed. RESULTS: The results found that the Central region found to be the highest impact of increased agrochemical costs (91.0%) and decreased crop yields (92.0%), while the highest in the North and the North-East was found in decreased crop product prices (84.0 and 66.4%). In the context of economic status, the greatest impact in the Central region was found to be in increased household expense (96.3%), while the highest impact in the North, the North-East, and the South was found in decreased household income (91.5, 80.0, and 69.8%, respectively). Regarding mental health, the Central region was found to be the highest prevalence of extremely high stress and severe depression symptoms (18.3 and 23.4%), whereas the South region was found to be the highest prevalence of severe anxiety symptoms (7.4%). Interestingly, the multivariate analysis also found that the agricultural factors associated with mental health were decreased working days, changes in agrochemical type and crop cultivation, decreased crop rotation, increased difficulty in accessing agrochemicals and markets, decreased crop yields, and increased household debt. CONCLUSION: The findings of this study are useful for government and relevant organizations to plan and implement supportive measures and improve mental health services to mitigate both short and long-term impacts of the COVID-19 pandemic suit on the regions. Specific measures and facilities should be tailored toward the target regions.

Association between kratom (Mitragyna speciosa) use and metabolic syndrome.

Background and aims: There are evidence about effects of kratom (Mitragyna speciosa) use on parameters related to metabolic syndrome (MetS). The present study aimed to determine the association between kratom use and MetS. Methods: This study is a cross-sectional study of 581 subjects (kratom users and non-users) aged 18 and over from the Nam Phu sub-district, Surat Thani province, Thailand. The association was determined using multivariate logistic regression. Results: MetS prevalence in kratom users and non-users was 11.9% (95% CI, 8.4-16.3%) and 21.6 % (95% CI, 17.1-26.8%), respectively. The use of kratom was associated with the lower odds of MetS (adjusted OR, 0.56; 95% CI, 0.33-0.96). Kratom use were associated with smaller waist circumference, lower triglycerides, and higher high-density lipoprotein. Conclusions: The current study demonstrated a potential protective effect of kratom use against MetS.

Health Information Sources Influencing Health Literacy in Different Social Contexts across Age Groups in Northern Thailand Citizens.

Health literacy is an essential social determinant of health and has been associated with positive health outcomes. While many sources of health information are widely available, people of different ages also have diverse social contexts and preferences for health information sources. This study aimed to identify health information sources and socio-demographics influencing health literacy in different social contexts across age groups: 15-29 years (young), 30-59 years (middle-age), and ≥60 years (elderly). We obtained secondary data from a cross-sectional study in northern Thailand from March to August 2019. Multivariate linear regression with age group subgroup analysis was used to determine factors associated with general health literacy by the Thai version of the health literacy questionnaire. Receiving health information from physicians was significantly associated with higher general health literacy in young (ß 6.45, 95%CI 0.44-12.45; p = 0.035) and elderly (ß 5.18, 95%CI 1.84-8.52; p = 0.002) groups, while receiving health information from health volunteers was significantly associated with a higher general health literacy in the middle-aged (ß 2.89, 95%CI 0.38-5.39; p = 0.024) group. Although younger participants showed more frequent access to health information via the media than the other age groups, there were no media sources significantly linked with their general health literacy. Health information from physicians is a vital source of health information.

Association between climate variables and dengue incidence in Nakhon Si Thammarat Province, Thailand.

The tropical climate of Thailand encourages very high mosquito densities in certain areas and is ideal for dengue transmission, especially in the southern region where the province Nakhon Si Thammarat is located. It has the longest dengue fever transmission duration that is affected by some important climate predictors, such as rainfall, number of rainy days, temperature and humidity. We aimed to explore the relationship between weather variables and dengue and to analyse transmission hotspots and coldspots at the district-level. Poisson probability distribution of the generalized linear model (GLM) was used to examine the association between the monthly weather variable data and the reported number of dengue cases from January 2002 to December 2018 and geographic information system (GIS) for dengue hotspot analysis. Results showed a significant association between the environmental variables and dengue incidence when comparing the seasons. Temperature, sea-level pressure and wind speed had the highest coefficients, i.e. ß=0.17, ß= -0.12 and ß= -0.11 (P<0.001), respectively. The risk of dengue incidence occurring during the rainy season was almost twice as high as that during monsoon. Statistically significant spatial clusters of dengue cases were observed all through the province in different years. Nabon was identified as a hotspot, while Pak Phanang was a coldspot for dengue fever incidence, explained by the fact that the former is a rubber-plantation hub, while the agricultural plains of the latter lend themselves to the practice of pisciculture combined with rice farming. This information is imminently important for planning apt sustainable control measures for dengue epidemics.

High serum high-density lipoprotein and low serum triglycerides in Kratom users: A study of Kratom users in Thailand.

OBJECTIVE: The present study aims to examine the association between Kratom use and serum lipid level. METHOD: This study compared the serum lipid profile of Kratom users and non-users living in Nam Phu Subdistrict, a special area that allows the traditional use of Kratom. The study subjects consisted of 581 individuals aged 18 and above. Binary logistic regression was used to determine an association between Kratom use and serum lipid level. RESULTS: The findings revealed an association between Kratom use and an elevated HDL level (≥60 mg/dL) with an adjusted OR of 1.82 (95% CI, 1.17-2.8), and an association between Kratom use and a triglyceride level <90 mg/dL with an adjusted OR of 1.75 (95% CI; 1.17-2.63). There were no associations between Kratom use and LDL as well as total cholesterol level. DISCUSSION AND CONCLUSIONS: This study provided additional evidence of Kratom use and a favorable lipid profile. Prevention of coronary heart disease or cerebrovascular disease via an improvement in the lipid profile may be a future pharmaceutical application of Kratom.

The current status of osteoporosis after 15 years of reduced cadmium exposure among residents living in cadmium-contaminated areas in northwestern Thailand.

The purposes of this study were to determine the prevalence of osteoporosis after 15 years of reduced cadmium exposure and to determine the association between urinary cadmium (U-Cd) and osteoporosis. The study was conducted with 937 participants (109 males, 828 females) living in a cadmium-contaminated area in northwestern Thailand. All participants were required to respond to a questionnaire. Bone mineral density (BMD) was investigated by measurements taken at the calcaneus by dual-energy X-ray absorptiometry. U-Cd, which reflects the amount of cadmium contained in the body, was measured by atomic absorption spectrophotometry (AAS). The geometric mean of U-Cd was significantly higher in males than in females (p < 0.001). The mean level of BMD for females was found to be statistically significantly lower than that for males (p < 0.001). Increasing U-Cd levels were correlated with decreasing levels of BMD. The association between U-Cd and osteoporosis appeared to exist only at concentrations of U-Cd ≥ 10 µg/g creatinine (OR = 2.7, 95% CI = 1.2-5.9). It can be concluded that despite discontinued or reduced cadmium exposure for more than 10 years, the effect of cadmium toxicity on bone, which is stronger in women, continues, as cadmium, once absorbed, will accumulate in the human body for a long time due to its extremely long half-life.

Association between urinary cadmium and chronic musculoskeletal pain in residents of cadmium-contaminated area in Northwest Thailand.

Cadmium exposure is known to cause adverse health effects in different organs of the human body but whether the effects result in chronic musculoskeletal pain (CMP) remain inclusive. The present study, therefore, aims to examine the relationship between urinary cadmium levels and CMP. An observational retrospective cohort study was conducted in two areas having different levels of cadmium contamination for comparison. The subjects enrolled into the study were individuals ages 18 and above who have lived in the studied areas for 1 year or more. The evaluation of chronic pain was carried out using a questionnaire and urine samples were collected for analysis of urinary cadmium levels. The data were analyzed using multiple logistic regression. The likelihood of CMP increased in a correlation with elevations in urinary cadmium from < 0.359, 0.359-0.753, 0.754-1.742, and ≥ 1.743 µg/g creatinine, adjusted odds ratio 1.07 (95% CI 0.62-1.86), 1.33 (95% CI 0.76-2.32), and 2.26 (95% CI 1.28-3.99) respectively. A positive association was found in our study between urinary cadmium level and CMP suggesting that cadmium exposure might cause neurological damage and/or tissue/muscle injury which in turn causing CMP.

Recommended Rice Intake Levels Based on Average Daily Dose and Urinary Excretion of Cadmium in a Cadmium-Contaminated Area of Northwestern Thailand.

This study was performed to investigate the dose-response relationship between average daily cadmium dose (ADCD) from rice and the occurrence of urinary cadmium (U-Cd) in individuals eating that rice. This was a retrospective cohort designed to compare populations from two areas with different levels of cadmium contamination. Five-hundred and sixty-seven participants aged 18 years or older were interviewed to estimate their rice intake, and were assessed for U-Cd. The sources of consumed rice were sampled for cadmium measurement, from which the ADCD was estimated. Binary logistic regression was used to examine the association between ADCD and U-Cd (cut-off point at 2 µg/g creatinine), and a correlation between them was established. The lowest estimate was ADCD = 0.5 µg/kg bw/day [odds ratio (OR) = 1.71; with a 95% confidence interval (CI) 1.02-2.87]. For comparison, the relationship in the contaminated area is expressed by ADCD = 0.7 µg/kg bw/day, OR = 1.84; [95 % CI, 1.06-3.19], while no relationship was found in the non-contaminated area, meaning that the highest level at which this relationship does not exist is ADCD = 0.6 µg/kg bw/day [95% CI, 0.99-2.95]. Rice, as a main staple food, is the most likely source of dietary cadmium. Abstaining from or limiting rice consumption, therefore, will increase the likelihood of maintaining U-Cd within the normal range. As the recommended maximum ADCD is not to exceed 0.6 µg/kg bw/day, the consumption of rice grown in cadmium-contaminated areas should not be more than 246.8 g/day. However, the exclusion of many edible plants grown in the contaminated area from the analysis might result in an estimated ADCD that does not reflect the true level of cadmium exposure among local people.