Factors associated with hypertriglyceridemia among the hill tribe people aged 30 years and over, Thailand: a cross-sectional study.

BACKGROUND: Triglycerides are lipids in the human body that are produced from the consumption of daily food and drink. However, elevated serum triglycerides, also known as hypertriglyceridemia (HTG), are key biomarkers indicating an unhealthy status and increased risks of cardiovascular diseases (CVDs) and pancreatitis. Different groups of people have different patterns and styles of cooking and different patterns of consumption, such as hill tribe people, who have their own unique culture and cooking practices. This study aimed to estimate the prevalence of and determine the factors associated with HTG among the hill tribe population in Thailand. METHOD: A cross-sectional study was performed. Data and a-5 mL blood sample were collected from participants who were members of one of the six main hill tribes in Thailand: Akah, Lahu, Hmong, Yao, Karen, and Lisu. People who lived in 30 selected hill tribe villages and aged 30 years over were asked to participate the study. Pearson correlation and logistic regression were used to detect the correlations and determine the associations between variables, respectively, at a significant level of α = 0.05. RESULTS: A total of 2552 participants participated this study; 65.9% were females, 72.35% were aged 40-69 years, 76.7% had no education, 48.7% worked in the agricultural section, and 71.2% had an annual income of less than 50,000 baht/family. Regarding the triglyceride level, 41.7% of participants had elevated levels of serum triglyceride or HTG; 16.4% had a borderline high level, and 25.3% had a high level. After controlling for all potential confounder factors, three variables were found to be associated with elevated serum triglycerides. Those who were members of the Lahu and Hmong tribes were 1.62 times (95%CI = 1.25-2.01) and 1.63 times (95%CI = 1.23-2.16) more likely to have elevated serum triglycerides than those who were members of the Akha tribe, respectively. Those who used a high quantity of cooking oil for daily cooking were 0.73 times less likely to have an abnormal level of triglycerides than those who used a low quantity of cooking oil for daily cooking (95%CI = 0.58-0.91), and those who had a waist circumference indicating obesity were 1.28 times more likely to have an abnormal level of triglycerides than those who had a normal waist circumference (95%CI = 1.08-1.52). CONCLUSION: Public health programs that focus on encouraging people to have regular exercise to reduce their body weight, particularly in some tribes, such as Lahu and Hmong, should be implemented.

Factors associated with elevated low-density lipoprotein cholesterol levels among hill tribe people aged 30 years and over in Thailand: a cross-sectional study.

BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) is one of the most important types of cholesterol and has an impact on health. Certain lifestyle and dietary habits in different populations may leads to increased levels of LDL-C, particularly among those with poor education and economic statuses, such as hill tribe people in Thailand. This study aimed to estimate the prevalence of and determine the factors associated with high LDL-C levels among hill tribe people in northern Thailand. METHODS: A cross-sectional study was performed to gather information from six main hill tribe populations: Akha, Lahu, Hmong, Yao, Karen, and Lisu. Individuals who were aged over 30 years and living in 30 selected hill tribe villages were invited to participate in the study. A validated questionnaire and 5-mL blood specimens were used to obtain data. Correlation analyses, chi-square tests, t-tests, and logistic regression were used to detect correlations and associations. RESULTS: A total of 2552 participants were recruited into the study; 65.9% were females, and 64.1% were aged younger than 60 years old. Approximately 69.6% of participants had abnormal LDL-C levels; 33.6% had above-optimal levels, 24.3% had borderline high levels, 8.0% had high levels, and 3.7% had very high levels. A total of 17.4% of participants had low high-density lipoprotein cholesterol (HDL-C) and high LDL-C levels, while 14.9% had high triglyceride and LDL-C levels. After controlling for sex, age, religion, education, annual family income, and marital status in the multivariate model, three variables were found to be associated with high LDL-C levels: occupation, the amount of lard used in daily cooking, and glycated hemoglobin (HbA1c). Those who were working as agriculturalists had a 1.34-fold greater chance of having abnormal LDL-C than traders and others (95% CI = 1.09-1.34). Those who used moderate and high quantities of lard in their daily cooking had a 1.45-fold (95% CI = 1.15-1.82) and 1.31-fold (95% CI = 1.04-1.68) greater likelihood of having abnormal LDL-C levels than those who used low quantities, respectively. Those who had abnormal HbA1c levels were less likely to develop abnormal LDL-C levels than those who had normal HbA1c levels (AOR = 0.69, 95% CI = 0.51-92). CONCLUSIONS: Effective public health programs that do not conflict with the cultures of hill tribes are urgently needed, particularly programs encouraging the use of small quantities of lard for daily cooking practices.

Association of environmental factors and high HFMD occurrence in northern Thailand.

BACKGROUND: The major population vulnerable to hand, foot and mouth disease (HFMD) is children aged less than 5 years, particularly those who are cared for at day care centers (DCCs). This study aimed to assess the associations of environmental and sanitation factors with high HFMD occurrence rates in DCCs of northern Thailand. METHODS: A case-control study was used to gather information from caregivers and local government administrative officers. DCCs in areas with high and low HFMD occurrence rates were the settings for this study. A validated questionnaire was used to collect environmental and sanitation information from the DCCs. In-depth interviews were used to collect information from selected participants who were working at DCCs and from local government administrative officers on the HFMD capacity and prevention and control strategies in DCCs. Logistic regression analysis was used to determine the associations between many environmental factors and HFMD at the α = 0.05 significance level while the content analysis was used to extract information from the interviews. RESULTS: Two variables were found to be associated with a high rate of HFMD occurrence: the number of sinks available in restrooms and the DCC size. Children attending DCCs that did not meet the standard in terms of the number of sinks in restrooms had a greater chance of contracting HFMD than children who were attending DCCs that met the standard (AOR = 4.21; 95% CI = 1.13-15.04). Children who were attending a large-sized DCC had a greater chance of contracting HFMD than those attending a small-sized DCC (AOR = 3.28; 95% CI = 1.21-5.18). The yearly budget allocation and the strategies for HFMD control and prevention, including collaborations among stakeholders for HFMD control and prevention in DCCs, were associated with the effectiveness of HFMD control and prevention. CONCLUSIONS: The number of sinks in restrooms and DCC size are major concerns for HFMD outbreaks. Sufficient budget allocation and good collaboration contribute to effective strategies for preventing and controlling HFMD in DCCs.

Prevalence of and factors associated with depression among hill tribe individuals aged 30 years and over in Thailand.

BACKGROUND: Depression is a silent health problem that can lead to severe and sometimes fatal outcomes if individuals are not diagnosed and treated properly; this is particularly true in populations with limited education, low economic status and several barriers to accessing health services, such as the hill tribe people in Thailand. METHODS: This cross-sectional study aimed to explore the prevalence of and factors associated with depression among hill tribe individuals aged 30 years and over. A validated questionnaire and the Patient Health Questionnaire-9 (PHQ-9) were used for data collection in an interview format in a private and confidential room. Logistic regression was used to detect the associations of variables with depression at a significance level of α = 0.05. RESULTS: A total of 2,552 participants were recruited for the analysis; 65.9% were females, 79.9% were married, 35.8% were aged 50 years and over, and 54.2% were Buddhist. The majority were uneducated (76.7%), were agriculturalists (48.4%), and had a low family income (71.2%). The overall prevalence of depression was 12.0%. In the multivariate analysis, eight variables were found to be significantly associated with depression among hill tribe adults aged 30 years and over in Thailand. Being female, 50 years or older, married, and Christian; living with a relative; smoking; using opium; and having moderate and high stress levels were associated with depression. CONCLUSION: Effective public health interventions should be considered to reduce the burden of depression in the hill tribe population by focusing on individuals who are female, 50 years or older, married, Christian, and stressed and those who abuse substances.

Prevalence of and factors associated with hypertension among the hill tribe population aged 35 years and over in northern Thailand: a cross-sectional study.

BACKGROUND: Hypertension (HT) is a serious noncommunicable disease that can lead to several health problems when it is not detected or is not properly diagnosed and treated in a timely manner, particularly in individuals living in poor economic and education conditions. The hill tribe population in northern Thailand is a vulnerable population with limited information available regarding HT. METHODS: The study aimed to estimate the prevalence of HT and to determine the factors associated with HT among individuals from hill tribes aged 35 years and over and living in northern Thailand. A cross-sectional study was conducted to gather essential information from six main hill tribe groups: the Akha, Lahu, Karen, Hmong, Yao and Lisu tribes in Chiang Rai Province. A simple random method was used to select 30 hill tribe villages (5 villages for each tribe). People aged 35 years and over who lived in the selected villages were invited to participate in the study. A validated questionnaire and a 5-mL blood specimen were used as research instruments. A face-to-face interview was conducted to collect data after informed consent was obtained, and 5-mL blood specimens were drawn to determine the lipid profiles of the participants. Logistic regression was performed to determine the factors associated with HT at the significance level of α = 0.05. RESULTS: A total of 1,287 participants were recruited into the study: 60.5% were females, 30.4% were aged 35-44 years, 65.4% were illiterate, and 83.1% were married. The overall prevalence of HT was 24.3%, and the Yao tribe had the highest prevalence at 18.5%. In the multivariable analysis, three variables were found to be associated with HT: marital status, ability to read Thai, and exercise behavior. Those who were single and divorced had a 2.55 (95% CI = 1.23-5.06) and 2.69 times greater chance (95% CI = 1.10-6.59), respectively, of developing HT than those who were married. Those who could not read Thai had a 2.13 times greater chance (95% CI = 1.50-3.01) of developing HT than those who could read, and those who did not exercise and who exercised sometimes had a 1.96 (95% CI = 1.07-3.58) and 2.24 times greater chance (95% CI = 1.21-4.13), respectively, of developing HT than those who regularly exercised. CONCLUSION: A health screening program for the identification of new HT among the hill tribe population urgently needs to be implemented, followed by the introduction of a proper exercise program to reduce the risk of HT, particularly for those who are illiterate and for single or divorced people.

Drinking Water Investigation of Hill Tribes: A Case Study in Northern Thailand.

Hill tribes are a group of people who live in remote areas in northern Thailand. They typically use untreated water for drinking, that can lead several health problems. The six main hill tribes-Akha, Hmong, Karen, Lahu, Lisu, and Yao-were selected for the study. A validated questionnaire was used for data collection. Water samples were collected from the selected villages and tested for the quality at Mae Fah Luang University, Thailand. Results: the major sources of drinking water were mountain water supplies (74.3%), and commercial bottled water (21.4%). Easy access, sufficiency for the whole year, and food-drug administration sign labeled were the criteria used for selecting sources of drinking water. Colorless and safety were also used as a selection criteria for their drinking water in some tribes. Lisu, Karen, and Hmong treated their drinking water by boiling, while Akha and Lahu stored the water in certain containers to allow particle settling before drinking water without treatment. 42.0% of the water samples had a turbidity values <5 NTU, and total coliform and fecal coliform bacteria were detected in 100.0% of the samples. To prevent water-borne diseases among the hill tribe people, appropriate water treatments such as boiling, filtration, and disinfection are recommended.