Determinants of adherence to iron/folate supplementation during pregnancy in two provinces in Cambodia.

Iron supplementation can effectively control and prevent anemia in pregnancy. However, limited adherence is thought to be a major reason for the low effectiveness of iron supplementation programs.This research describes the factors influencing the adherence to iron/folate supplementation during pregnancy in Siem Reap and Kampong Cham provinces in Cambodia.Triangulation method, combining the quantitative and qualitative data collection methods, was performed for this study. A total of 177 women who gave birth during the year prior to the interview were selected for the quantitative survey. Ten women who gave birth during the year prior to the interview and 10 pregnant women were interviewed in-depth for the qualitative data.The χ2 test and binary logistic regression were used for statistical analysis. The findings showed an adherence rate of 47%. The logistic regression revealed that the number of supplements received, number of prenatal visits, and access to antenatal care were determinants of adherence (P<.05). In conclusion, access to and follow-up of antenatal care were considered elements essential to improve iron/folate supplementation. Community-based interventions, such as nutrition education and distribution of supplements, should be prioritized in the interventions to improve adherence in Cambodia.

Effectiveness of school network for childhood obesity prevention (SNOCOP) in primary schools of Saraburi Province, Thailand.

This research was designed to test the effectiveness of a school network for childhood obesity prevention (SNOCOP) in primary schools; a program that aimed to improve student behavior in terms of knowledge, attitude, intention towards obesity prevention, and their food consumption behavior. A quasi-experimental pretest-posttest time series study was conducted. By 2-stage stratified sampling selection 180 students from 6 schools were assigned to the intervention group and 195 students from 6 schools to the control group at Saraburi Province, Thailand in 2006- 2007. In addition, thirty-one participants being school administrators, teachers, parents, and community members from six schools formed the social network initiating the intervention. The schoolchildren in the intervention group improved their eating behavior, knowledge, attitude, intention towards obesity preventive behavior. The six schools of the intervention group changed school policies and school activities aiming to reduce the proportion of obesity among their student. No such activities could be observed in the control group. These findings suggest that the School-Social Network of Childhood Obesity Prevention program is an effective means to prevent childhood obesity.

Fruit and vegetable consumption and its recommended intake associated with sociodemographic factors: Thailand National Health Examination Survey III.

OBJECTIVE: To examine the fruit and vegetable consumption in Thailand, the percentage of Thais meeting recommended intakes and the association with sociodemographic factors. DESIGN: Cross-sectional survey with a stratified, three-stage, cluster probability sampling design. SETTING: Community-dwelling men and women participating in the Thailand National Health Examination Survey III. SUBJECTS: A total of 39 290 individuals aged >or=15 years were interviewed using a questionnaire to obtain information on sociodemographic characteristics and fruit and vegetable consumption. Daily fruit and vegetable consumption was estimated through the use of a short semi-qualitative FFQ. RESULTS: Overall, participants had average frequencies of fruit and vegetable consumption equal to 4.56 and 5.97 d/week, respectively. Average daily number of servings of fruit, vegetables and fruit plus vegetables were 1.46, 1.78 and 3.24, respectively. Intake amounts of fruit, vegetables and fruit plus vegetables varied by marital status and region, and were lower among males (except for vegetable intake), those of older age, those with low educational attainment, those with low monthly household income and those living in a rural area. Only 1/3, 1/4 and 1/4 of the population consumed the recommended >or=2, >or=3 and >or=5 servings/d for fruit, vegetables and fruit plus vegetables. Sociodemographic factors related to meeting the recommended intake of >or=5 servings/d for fruit plus vegetables included being female (OR = 1.13) and household income >or=50,000 Baht/month (OR = 1.66). CONCLUSIONS: The amounts of fruit and vegetables consumed by Thai participants were far below the level of current recommendations. Public education and campaigns on adequate consumption of fruits and vegetables should be targeted more towards low socio-economic groups.

The optimal cut-off points of body mass index which reflect the risk factors of cardiovascular disease in the urban Thai male population.

OBJECTIVE: To examine the optimal cut-off points of body mass index (BMI) which reflect the risk-level of cardiovascular disease (CVD) risk factors in urban Thai males. MATERIAL AND METHOD: A cross-sectional research was conducted on Thai males, aged 35-50 who worked and lived in Bangkok. Four hundred and thirteen government officers were selected for blood pressure, weight and height measurements. BMI were calculated and blood samples were collected for blood chemical analysis. Sensitivity, specificity and ROC curve analyses were used for data analysis. RESULTS: The prevalence of overweight subjects was 57.8 percent by the BMI > or = 23 kg/m2, i.e. the Asian cut-off point criteria, while it was only 32.7 percent by the BMI > or = 25 kg/m2, i.e. the WHO criteria. The cut-off points of BMI which corresponded with the at-risk level of SBP, DBP, TC, TG, LDL-C, and HDL-C were 23.5, 23.5, 22.5, 23.5, 23.0 and 24.0 kg/m2, respectively. BMI at 23.5 kg/m2 was suggested as the optimal cut-off point of BMI which reflects the risk-level of CVD risk factors. CONCLUSION: The findings indicated that the Asian criteria might be more appropriate for urban Thai males who have a sedentary lifestyle than that the WHO criteria. However, the further study with larger sample size is needed to confirm the cut-off point of BMI at 23.5 kg/m2.

Sexual behaviors during antiretroviral therapy among HIV-infected patients, Thailand.

An increasing trend in sexual risk behavior has occurred in the era of antiretroviral therapy (ART) in Thailand. This study was conducted to identify sexual risk behavior and examine relationships between unprotected sex and CD4 levels among HIV-infected patients receiving ART in the National Antiretroviral Program. A cross-sectional survey was conducted in 460 HIV-infected patients age 18-49 years who visited the out-patient clinic of Bamrasnaradura Infectious Diseases Institute in February 2006 by using a standardized self-administered questionnaire. The results show that 60.4% of participants were men. The median most recent CD4 cell count during the prior 6 months was 261 cells/mm3. Twenty-three percent of the participants who had no sexual activity after they knew their HIV positive status started having sex again after receiving ART with a 12-week median duration period from starting ART to having first sex. There was a significant difference between the number of those having sexual activity before and after starting ART (p-value=0.013). Fifty-six percent of participants had sex during the previous 6 months. Of these, 26.5% had sex with commercial partners and 28.4% with non-regular partners. Inconsistent condom use, with commercial partners or non-regular partners, in females (35.3-36.8%) was higher than in males (7.8-11.1%). Participants with a known HIV-negative regular partner were 0.25 times more likely to have unprotected sex than those with a known HIV-positive regular partner (adjusted OR, 0.25; 95%CI, 0.09-0.73). No association between unprotected sex and CD4 levels was found. The findings support the need for reinforcing risk reduction programs among HIV-infected persons, particularly couple counseling, and promoting awareness of risk of acquirring sexually transmitted infections and drug-resistant strains of HIV.

Development of screening indicators for ranking areas at risk of vitamin A deficiency in Thailand.

The objective of this study was to develop community based screening indicators for identifying areas at risk of vitamin A deficiency. Three hundred children aged 24-71 months in 12 villages of 3 provinces who were previously identified to have various degrees of vitamin A deficiency were randomly selected to participate in the study. These villages were located in Songkhla, Yala and Narathiwat provinces. Data collection included anthropometric measurements, serum retinol analysis, data on dietary intake, illness, and socioeconomic status. Subsamples of 120 children were taken for Modified Relative Dose Response. Statistics used for data analysis were factor analysis, discriminant analysis and Receiver Operating Characteristic curves. Sensitivity and specificity of the screening indicators were calculated and compared with the rate of vitamin A deficiency at > or = 15 per cent of children with serum retinol < 0.70 micromol/l. Findings revealed that the screening indicators could identify areas at risk of vitamin A deficiency with 83.3 per cent efficiency. Data to be used for identifying areas at risk of vitamin A deficiency included home and land ownership for agriculture, dietary intake of vitamin A, access to social services (maternal education and antenatal care), vaccination, infectious diseases (diarrhoea and upper respiratory tract infection with fever) and nutritional status.

A longitudinal causal relationship among cardiovascular risk factors in the employees of the government savings bank.

A longitudinal structural causal model was generated to examine the causal relationship among determinants which were composed of four personal factors, stress, four health behaviors, and BMI on five physiological risks for cardiovascular disease: SBP, DBP, FBS, TC and HDL-C in 1,019 bank employees, within a five-year interval. A fourteen-item food frequency questionnaire for assessing eating habits and the Health Opinion Survey for the stress test were included in the self-administered questionnaires. Weight, height and blood pressure were measured and blood samples were collected for blood chemical analysis. Data analysis by LISREL showed that the determinants in the proposed model explained as much as 96 per cent variation in physiological risks for CVD (R2 = 0.96, relative chi-square = 1.92, RMSEA = 0.03, GFI = 0.96 and AGFI = 0.95). The findings also indicated that current physiological status was affected by their status of age, education, health behaviors, BMI and physiological status 5 years ago.