Beliefs, taboos, usages, health perceptions, and practices toward wildlife among different ethnicities in Tak and Mae Hong Son Provinces, Thailand.

This concurrent qualitative study was carried out with the main objective to determine wildlife beliefs, taboos, usages, health perceptions, and practices among ten ethnic groups in four communities in Tak and Mae Hong Son provinces of Thailand from November 2020 to January 2021. We also gathered comprehensive information on study respondents' knowledge related to potential risk behaviors that could lead to zoonotic disease transmission and infection. Furthermore, we intended to use the study's findings to develop communication strategies and health literacy improvement interventions for mitigating risky behaviors, with a focus on ethnic groups and particular individuals who live in close proximity to forests and wildlife, to prevent future pandemics. Sixty-five respondents were purposively selected based on their extensive knowledge, active participation in local cultural contexts, beliefs, and exposure to wildlife contact or consuming game animals. Twenty (30.8%) participated in in-depth interviews (IDIs), while 45 (69.2%) participated in eight focused group discussions (FGDs). The results revealed that the characteristics of wildlife contact are similar and distinct based on their beliefs and taboos among various ethnic groups and study locations, which are influenced by cultural backgrounds and traditions. Although some ethnic groups do not have explicit restrictions on the consumption of wildlife, others adhere to specific beliefs and taboos that forbid the consumption or killing of specific wild animals. These beliefs frequently correspond with conservation initiatives, thereby facilitating the preservation of threatened species. The study also revealed a lack of appropriate health knowledge, perceptions, and practices regarding wildlife contact and consumption. As a result, it is recommended that public health officials and local governments develop and execute communication and education initiatives. These campaigns should aim to increase health literacy and promote safe handling, preparation, and cooking practices to reduce the risk of zoonotic disease transmission and infection effectively. Moreover, it is necessary to design and implement wildlife conservation education and outreach activities. The programs should promote environmental stewardship while considering the cultural contexts, beliefs, and practices of various ethnic groups. The activities should involve diverse stakeholders, including local leaders, religious influencers, community members, schoolteachers, students, health professionals, village health volunteers, and civil society organizations.

Assessing the acceptability and feasibility of reactive drug administration for malaria elimination in a Plasmodium vivax predominant setting: a qualitative study in two provinces in Thailand.

BACKGROUND: Reactive case detection (RACD) or testing and treatment of close contacts of recent malaria cases, is commonly practiced in settings approaching malaria elimination, but standard diagnostics have limited sensitivity to detect low level infections. Reactive drug administration (RDA), or presumptive treatment without testing, is an alternative approach, but better understanding regarding community acceptability and operational feasibility are needed. METHODS: A qualitative study was conducted as part of a two-arm cluster randomized-controlled trial evaluating the effectiveness of RDA targeting high-risk villages and forest workers for reducing Plasmodium vivax and P. falciparum malaria in Thailand. Key informant interviews (KIIs) and focus group discussions (FGDs) were conducted virtually among key public health staff, village health volunteers (VHVs), and household members that implemented or received RDA activities. Transcriptions were reviewed, coded, and managed manually using Dedoose qualitative data analysis software, then underwent qualitative content analysis to identify key themes. RESULTS: RDA was well accepted by household members and public health staff that implemented it. RDA participation was driven by fear of contracting malaria, eagerness to receive protection provided by malaria medicines, and the increased access to health care. Concerns were raised about the safety of taking malaria medicines without having an illness, particularly if underlying health conditions existed. Health promotion hospital (HPH) staff implementing RDA noted its operational feasibility, but highlighted difficulty in traveling to remote areas, and requested additional travel resources and hiring more VHVs. Other challenges were highlighted including the need for additional training for VHVs on malaria activities and the inability of HPH staff to conduct RDA due to other health priorities (e.g., Covid-19). More training and practice for VHVs were noted as ways to improve implementation of RDA. CONCLUSIONS: To maximize uptake of RDA, regular education and sensitization campaigns in collaboration with village leaders on the purpose and rationale of RDA will be critical. To alleviate safety concerns and increase participant safety, a rigorous pharmacovigilance program will be important. To accelerate uptake of RDA, trust between HPH staff and VHVs and the communities they serve must continue to be strengthened to ensure acceptance of the intervention. TRIAL REGISTRATION: This study was approved by the Committee on Human Research at the University of California San Francisco (19-28,060) and the local Ethics Committee for Research in Human Subjects at Tak Provincial Health office (009/63) and Kanchanaburi Provincial health office (Kor Chor 0032.002/2185). Local authorities and health officers in the provinces, districts, and villages agreed upon and coordinated the implementation of the study. All methods in this study were carried out in accordance with relevant guidelines and regulations.

Risk factors for bat contact and consumption behaviors in Thailand; a quantitative study.

BACKGROUND: Bats serve as an important reservoir for emerging infectious diseases. Bat contact and consumption, which persists in Asia, poses risks for the transmission of bat-borne infections. METHODS: An analytical cross-sectional survey for risk factors associated with bat contact and consumption behaviors was conducted in ten provinces of Thailand from May 2016 to December 2017. A standardized questionnaire administered through face-to-face interviews was used to collect information from 626 villagers who lived in or nearby areas of high bat density. The questionnaire contained 23 independent variables related to sociodemographic, knowledge, attitudes, practices, and perceptions. RESULTS: The respondents (n = 626) were 285 females and 341 males, mean age of respondents was 47.58 years-old and lived in rural setting. Our results showed that 36.42% of respondents (n1 = 228) in 10 provinces reported bat contact during the past 6 months. Furthermore, 15.34% of respondents (n2 = 96) in 9 out of 10 provinces reported of having consumed bat meat in the past 6 months. Risk factors for bat contact included sex (male) (OR = 1.56, 95% CI 1.09-2.28), educational attainment (lower than secondary school) (OR = 1.45, 95% CI 1.02-2.18), and the consideration of bats as being economically beneficial to the community (OR = 3.18, 95% CI 2.03-4.97), while agriculture-related occupation (OR = 0.54, 95% CI 0.37-0.79), knowledge that it is safe to eat bats (OR = 0.58, 95% CI 0.37-0.93), practice of allowing children to play with bats (OR = 0.65, 95% CI 0.44-0.96), and attitude of feeling safe in areas where bats live (OR = 0.56, 95% CI 0.38-0.86) were statistically significant protective factors against bat contact. Risk factors for bat consumption included sex (male) (OR = 2.48, 95% CI 1.49-4.11) and educational attainment (lower than secondary school) (OR = 2.21, 95% CI 1.27-3.85), while knowledge of whether bats are safe to eat (OR = 0.04, 95% CI 0.01-0.25), knowledge of whether there are laws pertaining to hunting bats for consumption (OR = 0.35, 95% CI 0.18-0.71), and the practice of allowing children to play with bats (OR = 0.51, 95% CI 0.31-0.81) were statistically significant protective factors against bat consumption. CONCLUSIONS: This study provides a better understanding of the sociodemographic factors, knowledge, attitudes, perceptions and practices that might influence bat contact and bat consumption behaviors. Information on risk factors can be used for the development of appropriate education and communication interventions to promote proper knowledge, attitudes and practices regarding bats and bat-borne zoonotic diseases in Thailand and other areas in the Southeast Asia region with similar environmental and cultural characteristics.

Rodent consumption in Khon Kaen Province, Thailand.

Rodents are important reservoirs of rodent-borne infections worldwide, including Southeast Asia and Northeast Thailand (Isaan), where rodent consumption may be a source of rodent-borne diseases. The behavior of consuming rodents is related to a population's traditions, knowledge, cultural, and household contexts, among other factors. This cross-sectional survey was conducted in Khon Kaen Province, Thailand during November-December 2011. It aimed to elicit information about rodent consumption among residents of this province, and to identify factors associated with rodent consumption there. Multiple logistic regression analysis indicated that male gender, large family size, and use of rainwater as the main source of drinking water were positively associated with reported rodent consumption in this province, while having proper knowledge/attitudes towards animal-borne disease was negatively associated. These results provide evidence-base information for further studies, such as participatory ac- tion research, to further explore how people interact with rodents in different contexts. Further research is also needed to characterize risk of zoonotic diseases in relation to rodent consumption.

Investigating the impact of climate and seasonality on mosquito (Diptera: Culicidae) vector populations in the connecting areas of the Tenasserim range forests in Thailand.

Mosquito-borne diseases pose a significant public health challenge globally. Our study focused on the seasonal diversity of mosquito species in the connecting areas of the Tenasserim (also known as Tanaosri) range forests in Thailand. Additionally, we employed the geometric morphometric technique to assess variations in wing size and shape among five predominant mosquito species. Throughout the study period, we collected a total of 9,522 mosquitoes, encompassing 42 species across eight genera. In these connecting areas of forests, the Simpson index and Shannon species diversity index were recorded at 0.86 and 2.36, respectively, indicating a high level of mosquito diversity. Our analysis using the Analysis of Similarities (ANOSIM) test showed significant seasonal differences in mosquito communities, with an R-value of 0.30 (p < 0.05) in the lower connecting areas and 0.37 (p < 0.05) in the upper connecting areas. Additionally, canonical correspondence analyses showed that the abundance of each mosquito species is influenced by various climate factors. Phenotypic analyses of wing size and shape have deepened our understanding of local adaptation and the seasonal pressures impacting these vectors. Notably, most species exhibited larger wing sizes in the dry season compared to other seasons. Additionally, seasonal assessments of wing shape in five predominant mosquito species revealed significant differences across seasonal populations (p < 0.05). Ongoing monitoring of these populations is crucial to enhancing our understanding of the seasonal effects on mosquito abundance and physiological adaptations. These insights are essential for developing more effective strategies to manage mosquito-borne diseases.

A qualitative study on wildlife contact and healthcare-seeking behaviors among a cluster of Mani ethnic group in Manang district, Satun province of Thailand.

Mani, or Maniq, or Sakai, are recognized as indigenous hunter-gatherers. Some are nomadic, while others have settled and modernized. Our knowledge of this ethnic group's healthcare-seeking and wildlife contact is limited. Thus, this qualitative study examined healthcare practices and wildlife interaction among a cluster of Mani ethnic group members in Manang District, Satun Province, Thailand, from November to December 2022. Four key informant interviews (KIIs) and focus group discussions (FGDs) were carried out, and the selection of the study respondents was based on information from a gatekeeper and local health officials. Coding, thematic, content, and triangulation analyses of audio transcriptions were implemented based on the study objectives. Mani's beliefs and lifestyle are deeply rooted in the forest, which significantly impacts numerous aspects of their lives. They encountered challenges such as food scarcity, legal issues, and access to modern healthcare. However, since obtaining national identification cards, their mobility has decreased. Their way of life has also changed, as they've become more dependent on outsiders. Nevertheless, they continue engaging in traditional practices such as gathering food, hunting in the forest, and treating illnesses with herbal remedies. They rarely develop serious illnesses. They have decided to seek treatment only if their condition persists or worsens. In addition, their knowledge of COVID-19, zoonotic diseases, and emerging animal-borne diseases was limited. In this regard, relevant governments and organizations should improve their health literacy about zoonotic diseases spread by wild animals to promote appropriate wildlife contact practices and reduce the potential risk of infection.

A qualitative study on knowledge, attitude, and practice (KAP) toward swine influenza, information on pig farms and zoonosis reporting systems in Thailand.

This qualitative study aimed to determine knowledge, attitudes, and practices (KAP) on swine influenza (SIV) among pig farm owners, pig farm workers, community leaders, public health personnel, and villagers who lived nearby pig farms in the northeastern (Nakhon Ratchasima), northern (Chiang Mai), and central (Nakhon Pathom) provinces of Thailand during May to December 2022. The qualitative information was collected from 91 respondents, including 33 individuals who participated in key informant interviews (KIIs) and 58 individuals who joined ten focus group discussions (FGDs) (5-7 persons per FGD). Our results showed that pig farmers, farm workers, and villagers lacked SIV-related knowledge and did not employ preventive measures. Some respondents had limited access to information about causes, clinical symptoms, treatment, and appropriate practices resulting in inadequate knowledge, attitudes, and practices regarding zoonotic diseases, especially SIV. Some pig farmers and farm workers reported seeking information about SIV infection from various sources; however, relevant authorities lacked dissemination of information regarding SIV to community members. The study suggested that healthcare personnel and relevant agencies should adopt a community-based approach to prevent swine influenza. This can be achieved by organizing health education and community communication interventions and involving those who have had contact with pigs or reside near pig farms. This will help increase community awareness and knowledge of swine influenza.

Love or conflict: A qualitative study of the human-long tailed macaque interface in Nakhon Sawan Province, Thailand.

A wide range of zoonotic pathogens can be transmitted during human-wildlife interactions. Few qualitative studies have been conducted on human-nonhuman primate interfaces in Thailand, notably direct and indirect contact. Since Long-tailed macaques (LTMs) are prevalent in Thailand's Banphot Phisai district, part of Nakhon Sawan province, this qualitative study was conducted in 2019 to determine in-depth contact characteristics between humans and LTMs in the communities. Key informant interviews (KIIs) and focus group discussions (FGDs) were conducted with 35 villagers who reported close contact with LTMs in this study location. The results showed that villagers had different levels of contact with LTMs, depending on their occupations, perceptions, beliefs, religions, previous experiences, and local regulations. Monks in temples and vendors selling food for LTMs were reported to have the closest contact with them. LTMs have been reported to destroy personal property, houses, buildings, and crops. However, the villagers do not hurt them due to their religious beliefs relating to a respected abbot (a man who headed an abbey of monks). Even community members have had extensive interaction with LTMs, but they lacked awareness and information regarding diseases transmitted to humans directly or indirectly by non-human primates. Therefore, individuals who have frequent and close contact with LTMs should be provided health education, and appropriate behavioral change communication interventions should be performed. Furthermore, the results could be used to develop future disease prevention strategies and public awareness campaigns in the area.

Rodent-Human Interface: Behavioral Risk Factors and Leptospirosis in a Province in the Central Region of Thailand.

This sequential explanatory mixed-method study consisted of analytical, cross-sectional, and qualitative studies. The research was conducted in the Khao Nor and Khao Kaew areas of the Banphot Pisai districts of Nakhon Sawan Province in 2019. Here, we examined the rodent contact characteristics of villagers in these areas and determined the potential characteristics/risk factors associated with rodents using a semi-structured questionnaire, key informant interview (KII), and focus group discussion (FGD). Results of the quantitative study (N1 = 372) characterized participants that contacted rodents per gender, age, occupation, knowledge, attitude, and practice (KAP), including their cultural contexts, and beliefs. Ninety participants (24.2%) reported contact with rodents, and the reasons for their direct physical rodent contact were hunting (35, 9.4%), killing (41, 11.0%), preparing rodents as food (33, 8.9%), consuming cooked meats (12, 3.2%), feeding food (4, 1.1%), cleaning feces (17, 4.6%), and cleaning carcasses (33, 8.9%). Moreover, logistic regression results showed that males encountering rodents were statistically significant (Adjusted OR = 3.137, 95% CI 1.914-5.139, p < 0.001). Low monthly household income (

Coronavirus seroprevalence among villagers exposed to bats in Thailand.

A serological survey of human coronavirus antibodies among villagers in 10 provinces of Thailand was conducted during 2016-2018. Serum samples (n = 364) were collected from participants from the villages and tested for coronavirus antibodies using a human coronavirus IgG ELISA kit. Our results showed that 10.44% (38/364; 21 males and 17 females) of the villagers had antibodies against human coronaviruses. The odds ratio for coronavirus positivity in the villagers in the central region who were exposed to bats was 4.75, 95% CI 1.04-21.70, when compared to that in the non-exposed villagers. The sociodemographics, knowledge, attitudes and practices (KAP) of the villagers were also recorded and analysed by using a quantitative structured questionnaire. Our results showed that 62.36% (227/364) of the villagers had been exposed to bats at least once in the past six months. Low monthly family income was statistically significant in increasing the risk for coronavirus seropositivity among the villagers (OR 2.91, 95% CI 1.13-7.49). In-depth interviews among the coronavirus-positive participants (n = 30) showed that cultural context, local norms and beliefs could influence to bat exposure activities. In conclusion, our results provide baseline information on human coronavirus antibodies and KAP regarding to bat exposure among villagers in Thailand.

Bats and belief: A sequential qualitative study in Thailand.

Bats are wildlife and distribute globally. In Thailand, there are hundreds of bat species in different locations within four regions. However, few motivations and influences for having contact with bats have been documented. This sequential qualitative study was conducted in ten provinces representing the four regions of Thailand from September 2016 to June 2017. The study was designed to obtain information on villagers' attitudes, perceptions, beliefs and cultural contexts in relation to bats. Focus group discussions (FGDs) were conducted with 305 respondents. Of these respondents, 142 (46.6%) reported coming into contact with bats through various activities, such as hunting, eating, cooking, collecting bat guano, cleaning bat feces, and finding carcasses in houses and communities. Villagers called bats by different names in different regions. They reported having been in contact with bats in different ways based on occupations, bat species, bat habitats, attitudes, perceptions, beliefs toward bats, and cultural contexts. Villagers in the northern and northeastern regions reported having regularly eaten bats. In contrast, the respondents in the central region did not eat bats due to local norms, religious beliefs, and regulations. By ethnicity, the Blu and Thai Dum groups reported coming into contact with and eating bats more often than the Thais. Our results provide evidence-based information on the human-bat interface in different regions in Thailand. The results of this qualitative study could be useful for strategic planning of proper education and interventions for bat conservation, bat contact behavior, and risk of bat-borne diseases among villagers in the future.

Bat consumption in Thailand.

BACKGROUND: Human consumption of bats poses an increasing public health threat globally. Communities in which bat guano is mined from caves have extensive exposure to bat excreta, often harvest bats for consumption, and are at risk for bat-borne diseases. METHODS: This rapid ethnographic study was conducted in four provinces of Thailand (Ratchaburi, Sakaeo, Nakorn Sawan, and Phitsanulok), where bat guano was mined and sold during the period April-August 2014. The aim of this study was to understand behaviors and risk perceptions associated with bat conservation, exposure to bats and their excreta, and bat consumption. Sixty-seven respondents playing various roles in bat guano mining, packaging, sale, and use as fertilizer participated in the study. Data were collected through interviews and/or focus group discussions. RESULTS: In spite of a bat conservation program dating back to the 1980s, the benefits of conserving bats and the risks associated with bat consumption were not clear and infrequently articulated by study respondents. DISCUSSION: Since bat consumption continues, albeit covertly, the risk of bat-borne diseases remains high. There is an opportunity to reduce the risk of bat-borne diseases in guano-mining communities by strengthening bat conservation efforts and raising awareness of the health risks of bat consumption. Further research is suggested to test behavior change strategies for reducing bat consumption.

Characteristics associated with contact with rodents in, around, and outside homes in Khon Kaen Province, Thailand.

Rodents are an important reservoir for zoonotic diseases. To enhance the evidence on the human-rodent interface, this cross-sectional study was conducted in 2011 to investigate characteristics associated with rodent contact in Khon Kaen Province, Thailand. A standardized, interviewer-administered questionnaire elicited information from 201 adults (101 males and 100 females). Overall, 86.6% of participants reported encountering or seeing evidence of rodents in or near the home, whereas 57.2% encountered rodents while working with crops. Encountering rodents in or near the home was positively associated with the number of agricultural activities, whereas encountering rodents during crop work was positively associated with perceiving that disease can be acquired from rodents, the number of food crops grown, the number of agricultural activities, and living in a house with wooden walls. Surprisingly, neither outcome was associated appreciably with gender, age, or setting (urban, forest, or agricultural). These results provide information on the potential risk of rodent-borne zoonoses; this evidence has implications for risk communication strategies in this province and likely elsewhere.

Hunting, Food Preparation, and Consumption of Rodents in Lao PDR.

A cross-sectional study was conducted in 29 villages of Khamkeuth District in Bolikhamxay Province in the Lao PDR during March to May 2013. The study aimed to determine the characteristics associated with rodent consumption and related behaviors among different ethnic groups, ages, and genders. Five-hundred-eighty-four (584) males and females from 18-50 years of age participated in this study. Half of them were Hmong (292, 50%) while 152 respondents were Lao-Tai (26%) or other ethnic groups (140, 24%). Most of the respondents (79.5%) had farming as their main occupation. Prevalences of the studied outcomes were high: 39.9 for hunting or capturing rodents in the previous year, 77.7% for preparing rodents as food, and 86.3% for rodent consumption. Multivariable logistic regression analysis showed that likelihood of these types of rodent contact was more consistently associated with behavioral factors (gathering things from the forest and elsewhere, cultivation-related activities, and taking measures to prevent rodent-borne disease) than with socio-demographic, environmental, or cultural factors. The strongest associations were observed for gathering things; these associations were consistently positive and statistically significant. Although this study did not directly assess rodent-borne zoonosis risk, we believe that study findings raise concern that such risk may be substantial in the study area and other similar areas. Further epidemiological studies on the association between rodent-borne disease infection and rodent hunting, preparation for food, and consumption are recommended. Moreover, further studies are needed on the association between these potential exposure factors (i.e., rodent hunting, preparation for food, and consumption) and rodent-borne infections, especially among ethnic groups like the Hmong in Lao PDR and those in neighboring countries with similar socio-demographic, environmental, behavioral and cultural contexts.