Relationship between Breast Cancer and Oral Contraceptive Use among Thai Premenopausal Women: a Case-Control Study

Background: Breast cancer (BC) is an important issue both in medicine and public health as it is the leading malignancy with high incidence and mortality among women worldwide. The objective of this research was to determine the associations of BC with oral contraceptive (OC) use among Thai premenopausal women (TPW). Materials and Methods: A case-control study was conducted among TPW attending the National Cancer Institute, with 257 cases and 257 controls in 2013-2014. Cases and controls were matched by age (± 5 years), residential area and duration of attendance. Data were collected with a questionnaire that comprised 2 sections: part 1 socio-demographic characteristics, and part 2 health risk behavior and reproductive factors. The obtained data were analyzed using descriptive and analytic statistics with a computerized statistical package. Results: The study participants were mainly 40-44 years old (60 %) with an average age of 39 years. The major BC type was invasive ductal carcinoma (91.8%). Multiple unconditional logistic regression analysis, controlling for possible confounding factors, revealed that TPW with OC use increased the risk of BC by a factor of over 3 times (ORadj=3.39, 95%CI =1.99-5.75). In addition, the greater the duration of OC, the greater the risk (ORadj 6-10 yrs=3.91, 95%CI = 1.99-7.64, ORadj >10 yrs=4.23, 95%CI = 2.05-8.71). Conclusions: From our findings, a surveillance system of cancer risk with OC use should be conducted, accompanied by an exercise promotion campaign among risk groups, providing information and counseling for physical exercise and physical activities, weight control and basic adjustment for a healthy lifestyle to reduce BC.

EFFECT OF INSTITUTION-BASED MANAGEMENT FOR ELDERLY HEALTH PROMOTION PROGRAM IN NORTHEASTERN THAILAND.

The increasingly aging population raises a major challenge for health care in Thailand and worldwide. Health promotion has been considered a strategy for improving elderly quality of life. There are a small number of elderly people living in government elderly services in Thailand, and little is known about their health promotion behaviors and how these behaviors have been shaped in an institution-based setting. This study aimed to examine the current situation and effectiveness of the Institution-based Management for Elderly Health Promotion (IBM-EHP) program in enhancing the health and health promotion behaviors of the elderly living in two out of five government elderly home service institutes (GEHSI) in northeastern Thailand. The elderly participants in one GEHSI were assigned into the management group and received the IBM-EHP program (n=60), and those in another GEHSI were in the control group and received the usual care provided by the institution (n=55). Before and after (six months) the program implementation, assessments of knowledge, self-efficacy, received social support, health promotion behaviors, and health status depicted by fasting plasma glucose level and lipid profile of the participants in both groups were performed. Data collection used an interview guide, and clinical and diagnostic measurement methods. Data analysis used frequency, mean, standard deviation, paired simple t-test, independent t-test, and multiple regression. Results indicated that the management group, compared to the control group, demonstrated improvements in perceived self-efficacy, received social support, health promotion behaviors, and HDL-C level (p<0.05). Perceived self-efficacy and received social support were predictive factors, which contributed to explain 50.6% of the health promotion behaviors of the institutionalized elderly participants in the management group. Modification solutions for suitable health promotion behaviors of the institutionalized elderly persons should emphasize on enhancing their self-efficacy and social support from the elderly home service institute and their peers.

FACTORS ASSOCIATED WITH DIABETIC RETINOPATHY AMONG TYPE 2 DIABETIC PATIENTS: A HOSPITAL BASED CASE-CONTROL STUDY.

The objective of this study was to determine factors associated with diabetic retinopathy (DR) among type 2 diabetics in Thailand. We conducted a hospital based case-control study in Nakhon Nayok Province, between August 2008 and July 2010. The subjects were comprised of 230 cases (with DR) and 230 controls (without DR) who were gender and age matched. All subjects were interviewed and their medical records were reviewed. Seventy-five percent of subjects were married and 42% were aged 60-69 years. Fifty-five percent had a primary school education, 27% had no occupation and 67% had family income > 10,000 Baht per month. On multiple logistic regression analysis, factors associated with DR were: having a fasting plasma glucose (FPG) of 141-160 mg/dl, 161-180 mg/dl and > 180 mg/dl [OR = 7.23; 95% confidence interval CI: 2.80-18.72; OR = 4.33; 95% CI: 1.66-11.33, and OR = 3.76; 95% CI: 1.39-10.18], having a HbA1c > 9% (OR = 2.26; 95% CI: 1.15-4.43), having a BMI ≥ 30 kg/m2 (OR = 2.09; 95% CI: 1.04-4.19), and having hypertension (OR = 1.80; 95% CI: 1.19-2.71). Elevated blood sugar, blood pressure and body weight are all associated with DR. Further study is needed to determine if controlling these factors could reduce the prevalence of DR.

Smoking prevalence among monks in Thailand.

Previous studies among Buddhist monks in Thailand have reported smoking rates to be as high as 55%. Because 95% of Thais are Buddhist, monks are highly influential in establishing normative behavioral patterns. As the first population-based study on smoking among Buddhist monks in Thailand, this study aims to determine the smoking prevalence in six regions of the country, and to examine smoking knowledge, risk perceptions, behaviors, and associated demographics among full-fledged and novice monks (n = 6,213). Results demonstrated that the overall prevalence for current smoking monks is 24.4% (95% confidence interval [24.453, 24.464]), with regional differences ranging from 14.6% (North) to 40.5% (East). Findings suggest that integrating prevention and cessation programming into religious courses may be one avenue for reaching many incoming monks. Further, involving monks in tobacco control education and setting a nonsmoking standard among them is vital to the success of reducing smoking rates among the general population in Thailand.

Current drinking and health-risk behaviors among male high school students in central Thailand.

BACKGROUND: Alcohol drinking is frequently related to behavioral problems, which lead to a number of negative consequences. This study was to evaluate the characteristics of male high school students who drink, the drinking patterns among them, and the associations between current drinking and other health risk behaviors which focused on personal safety, violence-related behaviors, suicide and sexual behaviors. METHOD: A cross-sectional study was conducted to explore current alcohol drinking and health-risk behaviors among male high school students in central Thailand. Five thousand one hundred and eighty four male students were classified into 2 groups according to drinking in the previous 30 days (yes = 631, no = 4,553). Data were collected by self-administered, anonymous questionnaire which consisted of 3 parts: socio-demographic factors, health-risk behaviors and alcohol drinking behavior during the past year from December 2007 to February 2008. RESULTS: The results showed that the percent of current drinking was 12.17. Most of them were 15-17 years (50.21%). Socio-demographic factors such as age, educational level, residence, cohabitants, grade point average (GPA), having a part time job and having family members with alcohol/drug problems were significantly associated with alcohol drinking (p < 0.05). Multiple logistic regression analysis, after adjusting for socio-demographic factors, revealed that health-risk behavioral factors were associated with current alcohol consumption: often drove after drinking alcohol (OR = 3.10, 95% CI = 1.88-5.12), often carried a weapon (OR = 3.51, 95% CI = 2.27-5.42), often got into a physical fight without injury (OR = 3.06, 95% CI = 1.99-4.70), dating violence (OR = 2.58, 95% CI = 1.79-3.71), seriously thought about suicide (OR = 2.07, 95% CI = 1.38-3.11), made a suicide plan (OR = 2.10, 95% CI = 1.43-3.08), ever had sexual intercourse (OR = 5.62, 95% CI = 4.33-7.29), alcohol or drug use before last sexual intercourse (OR = 2.55, 95% CI = 1.44-4.53), and got someone pregnant (OR = 3.99, 95% CI = 1.73-9.25). CONCLUSIONS: An increased risk of health-risk behaviors, including driving vehicles after drinking, violence-related behaviors, sad feelings and attempted suicide, and sexual behaviors was higher among drinking students that led to significant health problems. Effective intervention strategies (such as a campaign mentioning the adverse health effects and social consequences to the risk groups, and encouraging parental and community efforts to prevent drinking) among adolescents should be implemented to prevent underage drinking and adverse consequences.

Factors associated with alcohol consumption among male high school students in central Thailand.

A cross-sectional study was conducted to explore factors associated with alcohol consumption among male high school students in central Thailand. Five thousand one hundred eighty-four male students from central Thailand were classified into 2 groups according to alcohol consumption during the past year (yes = 916, no = 4,268). Data were collected by an anonymous self-reporting questionnaire which consisted of 2 parts: socio-demographic factors and alcohol drinking behavior during the previous year from December 2007 to February 2008. Descriptive statistics, a chi-square test and multiple logistic regression were used to analyze the data. Seventeen point seven percent of male high school students in this study reported consuming alcohol. Most of the students (73.4%) were 15 years old or younger. Univariate analysis revealed socio-demographic factors, such as age, educational level, residence, cohabitants, grade point average (GPA), having a job earning money and having family members with alcohol/drug problems were significantly associated with alcohol consumption (p < 0.05). Multiple logistic regression analysis, after adjusting for age, revealed five factors were associated with alcohol consumption: the educational level (OR MS3 = 2.69, 95% CI 2.07-3.49; OR MS5 = 5.50, 95% CI 4.25-7.13), cohabitants (OR Friends = 3.09, 95% CI 1.38-6.93), having a job earning money (OR = 1.37, 95% CI 1.13-1.66), having family members with alcohol/drug problems (OR = 1.33, 95% CI 1.11-1.60), and GPA (OR < 2 = 1.31, 95% CI 1.01-1.71; OR > 3 = 0.62, 95% CI 0.51-0.75). Approximately 38% drank more than 2 times a month, 35% drank more than 4 drinks each time, 60% experienced binge drinking, and 43% experienced drunkenness. These results suggest alcohol abuse preventive measures among male high school students should take into account education level, cohabitants, having a job earning money, family members with alcohol/drug problems and GPA. Education regarding the disadvantages of alcohol to risk groups could reduce the proportion of new and current drinkers.

Youth and alcoholic beverages: Drinking patterns among high school students in central Thailand.

The objective of this study was to determine the drinking patterns of high school students in central Thailand. Eleven thousand three hundred sixty high school students from central Thailand were divided into 2 groups (drinkers and nondrinkers) according to their alcohol consumption. Information was obtained by an anonymous self-reporting questionnaire which consisted of 2 parts: general characteristics, and characteristics of alcohol drinking behavior. Data were analyzed using descriptive and inferential statistics by a computerized statistical package. The socio-demographic factors related to the student's alcohol consumption during the previous 12 months were: age > 15 years old, male sex, grades 9 and 11 education level, living in a private dormitory, staying with a relative or a friend, having a grade point average <2.0 or >3.0, having a job earning money and having family members with alcohol/drug problems (p<0.05). Drinking patterns were classified into 5 categories: life time drinking, drinking during the previous year, drinking during the previous 30 days, binge drinking during the previous 30 days and drinking until intoxication during the previous 30 days. A higher proportion of drinking was reported by boys than girls. The prevalence of drinking increased in proportion to the educational level. The 3 main drinking places were parties (48.5%), at home or in the dormitory (37.5%) and in shops around the school (12.4%). Boys drank alcohol on average 1-2 times per month in 59.8% and 1-2 standard drinks per time in 38.6%. Eighty point one percent of girls drank alcohol 1-2 times per month and 1-2 standard drinks per time in 55.6%. Drinking alcohol among high school students should be controlled by limiting access to alcoholic beverages in order to reduce accidents, injuries, violence and alcohol-related health problems among young people.

Risk factors for cholangiocarcinoma in Khon Kaen, Thailand: a nested case-control study.

The present nested case-control study within the Khon Kaen cohort study was conducted to assess risk factors for cholangiocarcinoma (CCA) development. Cases were 108 subjects with proven CCA, by ultrasound at least, and controls also numbered 108, matched by sex, age (not more than 3 years difference) and period of recruitment to the cohort (not more than 3 months difference). A questionnaire was constructed based on that employed for the Khon Kaen cohort study recruitment. McNemar's chi-square test and conditional logistic regression were used for crude analysis and multiple conditional logistic regression for multivariate analysis. Results revealed a sex ratio of 2:1 for males:females. The current study found a statistically significant relationship when adjusted for other potential covariate factors between cholangiocarcinoma and the consumption of total fruits 3-4.6 times per day (OR= 0.32, 95% CI= 0.12-0.88) and history of Opisthorchis viverrini eggs in stools at recruitment plus consumption of meat <0.45 times per day (OR= 2.99, 95% CI= 1.04-8.62). The findings suggest that O. viverrini infestation is the strongest risk factor for development of cholangiocarcinoma and also suggests decrease in risk among individuals who consume more fruit.

A randomized controlled trial to improve the quality of life of type 2 diabetic patients using a self-help group program.

The purpose of study was to determine the effect of a self-help group program on the quality of life among type 2 diabetic patients. The study subjects were type 2 diabetic patients attending one of six studied health centers or a community hospital in Saraburi Province, Thailand. At each health center/hospital, the patients were randomly allocated into the intervention group attending the self-help group program or the control group receiving diabetic services. Information was collected from September 2007 to April 2008 using a structured questionnaire with interview technique at baseline, 12 and 24 weeks. One hundred forty-six patients completed the program. Five self-help group programs carried out for 16 weeks gave instruction regarding building-up good relationships, improvement of knowledge about diabetes and skills for dietary control, skills in physical exercise, improvement of group structure, improvement of training skills for group leaders, self-monitoring, motivation in self-care activities and sharing experiences among group members. Descriptive statistics were used to provide basic information regarding the two groups. For analytical purposes the chi-square test and t-test were applied. The majority (77.4 %) of study participants were females. Most patients were either > or = 50 years old (52%) or 40-49 years old (37%). The intervention resulted in significantly higher scores in quality of life compared to controls at 12 and 24 weeks (p < 0.05). The findings indicate the program is effective for improving perceived quality of life. The program focused on enhancement of experience sharing among group members and participation in problem-solving. We recommend implementing this program for diabetic patients and patients with other chronic diseases at primary health care level.

Drinking behavior among female high school students in central Thailand.

OBJECTIVE: To study the drinking behavior and factors associated with drinking among female High School students in central Thailand. MATERIAL AND METHOD: A cross-sectional study was conducted with 6,176 female students from central Thailand, who were classified into 2 groups according to their alcohol drinking practices in the past year (yes = 612, no = 5,564). Information was collected by an anonymous self-reporting questionnaire which consisted of 2 parts: socio-demographic factors, and alcohol drinking behavior during the past year from December 2007 to February 2008. Descriptive statistics, a chi-square test and multiple logistic regression were used to analyze the data. RESULTS: Of all these respondents 9.91% admitted to drinking alcohol. Most of the students were 15 years old or younger (61.80%). Univariate analysis revealed that socio-demographic factors such as age, educational level, residence, grade point average (GPA), having a job for earning money, and having family members with alcohol or drug problems were significantly associated with the student alcohol drinking (p < 0.05). Multiple logistic regression analysis, after adjusting for age, showed that only four factors were associated with alcohol consumption: the educational level (OR mathayomsuksa 5 = 3.39, 95% CI = 1.55-7.41; OR mathayomsuksa 3 = 2.29, 95% CI = 1.71-3.09), residence in a private dormitory (OR = 3.32, 95% CI = 1.01-10.27) and family members with alcohol or drug problems (OR = 1.72, 95% CI = 1.43-2.08), and a GPA greater than 3 (OR = 0.71, 95% CI = 0.58-0.86) (p < 0.05). The following for drinking practices were considered as inappropriate drinking behavior (20% drank over 2 times a month, 40% drank greater than 2 standard drinks each time, nearly 47% had experienced binge drinking, and one third had experienced drunkenness). CONCLUSION: The results suggested that preventive measures for alcohol abuse among female high school students should consider the educational level, residence within a private dormitory and family members with alcohol or drug problems. Continuous insistence regarding the disadvantages of alcohol to risk groups would reduce the proportion of new and current drinkers.

Quality of life and compliance among type 2 diabetic patients.

A cross-sectional study was conducted to explore the quality of life (QOL) and compliance among type 2 diabetic patients in Saraburi Province, Thailand. Compliance was assessed by evaluating dietary intake and life style patterns useful for diabetes patients to maintain health and prevent complications of the disease. A multistage sampling technique was used for selecting patients from 2 districts (Wihan Daeng and Nong Don) and subjects were classified into 2 groups according to a quality of life (QOL) score (good = 70, poor to moderate = 94) using WHOQOL-BREF-THAI criteria. Data were collected from September to December 2007 using a self-administered questionnaire. Simple descriptive statistics were used to provide basic information about the two groups and for analytical purposes the chi-square test and multiple logistic regression were applied. The majority (78.7%) of study participants were females. Most patients belonged to the age groups of either > 50 years (50%) or 40-49 years (36.6%). Bivariate analysis revealed socio-demographic factors were not significantly associated with QOL (p > 0.05). As far as compliance was concerned dietary control and drug intake were significantly associated with QOL (p < 0.05). Multivariate analysis indicated that overall compliance was associated with QOL (OR = 1.91, 95% CI = 1.02-3.57). We conclude that good QOL is significantly related to good compliance. Therefore, diabetic patients should be made aware that following the suggestions to prevent side effects of the disease and trying to stay healthy despite suffering from the disease will significantly improve their QOL.

Factors associated with alcohol consumption among upper secondary school students.

A cross-sectional study was conducted to explore factors associated with alcohol consumption among upper secondary school students in Nakhon Ratchasima Province. A multistage sampling technique was used for selecting 850 students from 6 schools and subjects were classified into 2 groups according to hazardous alcohol drinking (yes=107, no=743) by the Alcohol Use Disorders Identification Test (AUDIT). Data were collected by questionnaire from August to September 2005. Descriptive statistics, the chi-square test and multiple logistic regression were used to analyze data. The results showed the percent of hazardous drinking was 12.59. Most of the students were 5 < or =6 years old (51.41) and in the science program (52.68%). Univariate analysis revealed the socio-demographic factors of gender, grade point average (GPA), monthly expenditure, age, and educational level were significantly associated with alcohol drinking (p < 0.05). Sibling and peer alcohol intake were associated with hazardous alcohol consumption (p < 0 .05). Multivariate analysis, after adjusting for age, educational level and gender, revealed only 3 factors associated with male alcohol consumption: peer usual alcohol intake (OR = 23.46, 95% CI= 7.29-75.43) and peer occasional alcohol intake (OR = 5.57, 95% CI = 2.02-15.31), GPA > 3.0 (OR = 0.29, 95% CI= 0.11-0.73). Only 2 factors were associated with female alcohol drinking: peer usual alcohol intake (OR = 63.41, 95 CI= 9.24-435.31) and peer occasional alcohol intake (OR = 7.94, 95 CI= 1.89-33.43). As a result, peer groups and close friends should be considered carefully when attempting to reduce the risk of alcohol consumption.

Relationship between body size and severity of dengue hemorrhagic fever among children aged 0-14 years.

A hospital based case-control study was conducted from October 2002 to November 2003 among children aged 0-14 years at Queen Sirikit National Institute of Child Health (Children's Hospital), Bangkok, Thailand. This study focused on body size and severity of dengue hemorrhagic fever (DHF) in children. One hundred five patients diagnosed as having DHF grade III or IV were the cases and 105 diagnosed as having DHF grade I or II were controls. They were matched at a ratio of 1:1 by their gender and age (within 5 years). Normal growth charts were used to differentiate child body size into normal, thin and obese. Data were collected using face to face interviews with caregivers, questionnaires, laboratory and physical examination reports as research tools. Multiple logistic regression analysis revealed that only two variables were related to severity of DHF: obesity (OR = 3.00, 95 % CI = 1.20-7.48) and dengue virus type II (OR = 4.94, 95 % CI = 2.57-9.47), respectively. Other variables were childhood factors: duration of breast-feeding, education, and parity; caregivers factors: age, gender, marital status, education, occupation, family income, knowledge of DHF, antipyretic type, treatment before hospitalization, and duration of fever; environmental factors: history of DHF patients in house, house pattern, time from house to hospital, and residence; and etiological factors: type of infection and history of DHF among children. These factors showed no significant association (p > 0.05). This result can be utilized in a preventive and control program, particularly in more aggressive management of overweight children. Health personnel should continue to provide health education, particularly, signs and symptoms of shock, to the community and private sectors. Government and Non-Government Protective Projects in primary schools (5-9 years children) should be continued in the high risk groups.

Cigarette smoking among Thai Buddhist monks, central and eastern Thailand.

A cross-sectional study was conducted from June to December, 2003 among Thai Buddhist monks in 4 provinces of the central region (Nonthaburi, Pathum Thani, Saraburi and Chai Nat) and in 4 provinces of the eastern region (Chachoengsao, Rayong, Trat, and Sa Kaeo) of Thailand. Data were collected using face to face interviews, questionnaires, and physical examination reports (weight, height, heart rate, blood pressure, etc) as the research tools. This study focused on sociodemographics, history of illness, and smoking behavior. The proportion of the cigarette smoking was 47.6% of the total of 920 Buddhist monks. The age group 20-34 years, Maha Nikaya section and Public temple were the majority of the study subjects. Multivariate analysis revealed that only four factors were related to smoking consumption: dharma education, Naktharm To (grade 2) (OR = 0.6, 95% Cl: 0.4-0.9), Naktharm Aek (grade 3) or above (OR = 0.4, 95% Cl: 0.2-0.6); Lay education, secondary school (OR = 0.7, 95% Cl: 0.5-0.9), bachelor degree or above (OR = 0.4, 95% Cl: 0.2-0.8); systolic blood pressure > or = 140 mmHg (OR = 1.8, 95% Cl: 1.1-2.8) and history of respiratory illness (OR = 3.2, 95% Cl: 1.5-6.9). As a result, dharma education and well educated persons were the crucial factors which led to success in decreasing cigarette smoking. Smoking cessation campaigns and education of the consequences of smoking are strongly recommended among risk groups.

Behavioral factors and malaria infection among the migrant population, Chiang Rai province.

A cross-sectional study was conducted from January, 2001 to June, 2002 among some migrant populations, living in malaria endemic areas along the Thai-Myanmar border, in the Mae Fah Luang and Mae Sai districts, Chiang Rai Province, Northern Thailand using blood exams and face-to-face interviews as the research methods. This study focused on the knowledge and practice of primary malaria prevention, aimed at identifying the association between behavioral factors in migrant populations and malaria infection. P. vivax (51.8%) was detected more often than P. falciparum (47.7%). The proportion of malaria infections was 45.4% of the total of 421 blood examinations. The working age group (15-44 yr) and males were the majority of the study subjects. Two age groups (0-14 and 15-34 yr) and visiting or staying in the forest 14 days prior to the blood exam were significant risk factors. The ethnic group of Thai-Yai and hilltribe was a significant protective factor (p < 0. 05) compared to the Myanmar people. A poor knowledge of primary malaria prevention (63-68%), the presence of international migration, poverty, lack of malaria prevention resources, namely bednets (not using or taking them) and not using a smoky fire were factors which led to failure in primary prevention and control of malaria infections. Residence-workplace-living style in the forest need more consideration to serve the common failure of effective primary prevention.

Malaria infection among the migrant population along the Thai-Myanmar border area.

A population based case-control study was performed to determine factors associated with malaria infection among the migrant population, foreign nationals aged 15 years or over. Data were obtained from 217 malaria and 217 non-malaria patients attending the Vector-Borne Disease Control Units 6-9 (Thong Pha Phum and Sangkhla Buri districts) in Kanchanaburi Province and at the Vector-Borne Disease Control Units 1,9 (Mae Fa Luang and Mae Sai districts) in Chiang Rai Province, between June and December 2002. All study subjects were interviewed by trained interviewers using a structured interview form. The statistical analysis was carried out by the chi-square test and multivariate logistic regression: a p-value of less than 0.05 was considered to be statistically significant. The results showed that the study subjects were predominantly Thai-Yai and Myanmar. Plasmodium falciparum was the major type of the malaria (60.8%). Logistic regression analysis, controlling for possible confounding factors, revealed that residence located in the forest increased the risk of malaria infection by a factor of 6.29 (OR = 6.29, 95% CI = 1.56-25.42); outdoor stay < 7 and > 7 days prior to the blood examination also increased the risk by a factor of 4.34 and 4.13 respectively (OR = 4.34, 95% CI = 1.05-17.99; OR = 4.13, 95% CI = 1.29-13.13).

Malaria infection and life-style factors among hilltribes along the Thai-Myanmar border area, northern Thailand.

A cross sectional study was conducted between January, 2001 and June, 2002 to determine the life-style factors associated with malaria infection among hilltribes in the Chiang Rai Province, Mae Fah Luang district located along the Thai-Myanmar border, northern Thailand. The data collected were a thick blood film examination and a face-to-face interview using a local language interviewer at a mobile clinic or a home visit. The chi-square test, odds ratio, 95% confidence interval and multiple logistic regression were used as data analysis. P. vivax (61.3%) was detected more than P falciparum (38.2%). Parasitic infection was seen in 45.8% of a total of 417 blood examinations. The study area was in a valley covered with forests and small streams, which was ideal for a malaria epidemic. The communities were distributed along different ethnic groups. There were 12 ethnic groups, dominated by the Muser, Eko, and Akha tribes (60-70%). The risk factors included living or working in the forest, accompanying their family during movement through the forest, age < or =14 years (40.9%), poor knowledge of how to protect against malaria (75-80%), and unavailability of protection against malaria via long sleeved clothes, topical repellents, and insecticide treated nets (use and carry), which resulted in an increased exposure to malaria and risk for malaria infection.

Energy drinks consumption in male construction workers, Chonburi province.

This unmatched case-control study aimed to determine the relationship among caffeine drinks consumption known as "energy drinks consumption", drug dependence and related factors in male construction workers in Chonburi Province. It was conducted during December 15, 2001 and February 15, 2002. Data were collected using interview questionnaires. The logistic regression was used to control possible confounding factors. The subjects consisted of 186 cases who had consumed energy drinks for more than 3 months and 186 controls who had given up for more than 3 months. They were frequency/group matched by age group. There was statistically significant association among energy drinks consumption and overtime work, motivation from advertisements, positive attitude of energy drinks consumption, alcohol drinks, smoking and ex-taking Kratom behavior. Multivariate analyses revealed that only 5 factors were related to energy drinks consumption: marital status (OR = 1.88, 95%CI: 1.14, 3.11), overtime work (OR = 2.84, 95%CI: 1.73, 4.64), motivation from advertisements (OR = 2.72, 95%CI: 1.67, 4.42), positive attitude of energy drinks consumption (OR = 4.06, 95%CI: 1.65, 10.01) and ex-taking Kratom behavior (OR = 2.77, 95%CI: 1.19, 6.44). As a result, construction workers should be provided with the knowledge of energy drinks consumption, the effect of drug dependence behavior, and the advantages of safe and healthy food that is cheap, readily available, and rich in nutrients.

Hepatitis B carrier among married hilltribe women in northern Thailand.

A cross-sectional study of 540 married Akha and Lisaw women of reproductive age was conducted in Chiang Rai Province, Thailand, between June 1st and August 31st, 1999, in order to determine the seroprevalence of HBsAg and identify the risk factors for chronic HBsAg carriage. HBsAg was detected by the reverse passive hemagglutination technique (RPHA). Data were obtained by questionnaires and serological testing. There were 164 Lisaws and 376 Akhas: most were illiterate (88.71%) and the annual family income was < or = 9,999 baht (50.93%). The seroprevalence of HBsAg was 8.15%. Logistic regression analysis, controlling for possible confounding factors, revealed that one to five injections in the year prior to the study increased the risk of HBsAg carriage by a factor of 4.84 (95% CI = 1.42-16.49); more than six injections increased the risk by a factor of 5.84 (95% CI = 1.47-23.18).

Unintentional injuries among children aged 1-4 years at home.

A hospital based case-control study was performed to determine causes of unintentional injuries among children aged 1-4 years at home. Data were obtained by interviewing parents and guardians of 242 children at Lerdsin Hospital in Bangkok, from August to October 1999. The results showed that falls were the most common type of injuries (54.6%). The age of 2 years comprised the major group (28.9%). The study subjects were injured within the home (60.7%). Sunday and Saturday were the most frequent days of injuries (18.2% and 16.5% respectively). The proportion of cases involving playing with others was 71.1%. Most of the injuries occurred in the period 16.00-19.00 hours (32.2%). Head and neck were the main injured area (45.5%). The multivariate model showed that children who had previous injuries were 19.22 times more likely to be injured again than those who had not previously been injured. Children with vigorous physical activities also had a higher risk (OR = 19.73, 95% CI 6.11-63.74). Outdoor working mothers were at higher risk than houseworking mothers (OR = 4.14, 95% CI 1.57-10.93) of having children affects. Children who spent most of the daytime at their relatives' houses had a higher risk than those who stayed at their home (OR = 3.48, 95% CI 1.02-11.81), while, 37.9% of children injured at their relatives' houses and 50.8% of all injured children were without supervision.