Prevalence and distribution of trematodes hosted by Bithynia siamensis in Southern Thailand.

This study aimed to investigate the occurrence of larval trematode infections in bithyniid snails across five provinces in southern Thailand. A total of 1,413 Bithynia siamensis snails were collected between October 2021 and October 2022 using handpicking and scooping methods. Among these, 844 were identified as B. s. siamensis and 569 as B. s. goniomphalos. The snail samples were examined for parasitic infections in the laboratory using shedding and crushing methods. Among the 27 sampling sites, snails from 6 sites were infected with various trematode species (infection rate: 4.95%, 70/1,413). Evaluation of the morphological and internal organ characteristics of the cercariae allowed for the categorization of the trematodes into five species of trematodes (belonging to four families). The identified species included Echinochasmus pelecani (family: Echinostomatidae), Echinostoma revolutum (family: Echinostomatidae), Haematoloechus similis (family: Haematoloechidae), Loxogenoides bicolor (family Lecithodendriidae), and Stictodora tridactyla (family: Heterophyidae), and the infection rates for these species were 3.26% (46/1,413), 0.35% (5/1,413), 0.42% (6/1,413), 0.78% (11/1,413), and 0.14% (2/1,413), respectively. The cercariae from the identified trematode species were studied for DNA analysis. The phylogenetic lineage reveals relationships among the species, confirming the morphological distinctions.

Prevalence of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency among Malaria Patients in Southern Thailand: 8 Years Retrospective Study.

Erythrocytes deficient in glucose-6-phosphate dehydrogenase (G6PD) is more susceptible to oxidative damage from free radical derived compounds. The hemolysis triggered by oxidative agents such as primaquine (PQ) is used for the radical treatment of hypnozoites of P. vivax. Testing of G6PD screening before malaria treatment is not a common practice in Thailand, which poses patients at risk of hemolysis. This retrospective study aimed to investigate the prevalence of G6PD in malaria patients who live in Southern Thailand. Eight hundred eighty-one malaria patients were collected for 8-year from 2012 to 2019, including 785 (89.1%) of P. vivax, 61 (6.9%) of P. falciparum, 27 (3.1%) of P. knowlesi, and 8 (0.9%) of mixed infections. The DiaPlexC genotyping kit (Asian type) and PCR-RFLP were employed to determine the G6PD variants. The result showed that 5 different types of G6PD variants were identified in 26 cases (2.9%); 12/26 (46.2%) had Mahidol (487G>A) and 11/26 (42.3%) had Viangchan (871G>A) variants, while the rest had Kaiping (1388G>A), Union (1360C>T), and Mediterranean (563C>T) variants. G6PD Songklanagarind (196T>A) variant was not found in the study. Our result did not show a significant difference in the malaria parasite densities in patients between G6PD-deficient and G6PD-normal groups. According to our findings, testing G6PD deficiency and monitoring the potential PQ toxicity in patients who receive PQ are highly recommended.

Prevalence and risk factors of Campylobacter infection in goats in southern provinces of Thailand.

Campylobacter is a foodborne pathogen that could be isolated from various types of livestock, including small ruminant. The objectives of the current study were to investigate the prevalence of Campylobacter spp. in goats reared in the south of Thailand and identify the risk factors associated with Campylobacter infection of goat in Thailand. A total of 600 rectal swabs of goats from 45 farms in 6 provinces of Southern Thailand were collected during 2016-2020. To analyse the risk factors associated with Campylobacter infection in goat, data collection was conducted via structured questionnaires. Campylobacter isolation was performed by direct plating on modified charcoal cefoperazone deoxycholate agar (mCCDA). Polymerase chain reaction (PCR) was used to identify genus and species of the isolates. In total, 68 out of 600 rectal swab samples (11.33%; 95% CI 8.96 to 14.21%) collected from goats were positive for Campylobacter. The prevalence of Campylobacter spp. in the province level ranged from 0 to 31.48%. Interestingly, Campylobacter lanienae was the dominant species, followed by Campylobacter coli and Campylobacter jejuni. To investigate the risk factors associated with Campylobacter infection in goats, farm management factors, i.e. deworming, fencing around the house, housing design, number of animals on farm, use of antibiotics and vaccination, were included in logistic regression analysis. Statistical analysis revealed that the use of antibiotics and deworming were associated with Campylobacter infections in goats. The current study emphasises that the prudent use of antimicrobials and good agricultural practices should be applied in goat farming.

Mental health problems from direct vs indirect exposure to violent events among children born and growing up in a conflict zone of southern Thailand.

PURPOSE: This study aims to examine and compare the effects of direct and indirect exposure to armed conflicts on the mental health of primary school students in the three southernmost provinces of Thailand. METHODS: A school-based survey was conducted. Detailed exposure of traumatic events both directly and indirectly were measured by a self-completed questionnaire. Behavioral-emotional problems were measured by the Strength and Difficulty Questionnaire and screening for post-traumatic stress disorder (PTSD) was done using the Children's Revised Impact of Events Scale (CRIES). Multivariate analysis adjusted for gender and other covariates was used to determine the effect of direct and indirect exposure of armed conflict on mental health problems. RESULTS: Out of 941 students included in the study, almost half had direct exposure to an armed conflict event. Overall, 42.1% of students had at least one behavioral-emotional problem (47.6% and 38.5% in the direct- and indirect-exposed groups, respectively) and 30.5% was found to have PTSD (37.3% and 25.9% in the direct- and indirect-exposed groups, respectively). Students who had direct exposure to an armed conflict event had a two times higher odds of mental health problems than their peers. Other modifiable factors of mental health problems were receiving news from two sources including other adults and media, and exposure to other non-conflict-related traumatic life events. CONCLUSIONS: Children living in armed conflict areas of southern Thailand, although without any direct exposure to traumatic events, also suffered from mental health problems. Research on appropriate interventions for these children should be further conducted.

Molecular Surveillance of Pfkelch13 and Pfmdr1 Mutations in Plasmodium falciparum Isolates from Southern Thailand.

Artemisinin-based combination therapy (ACT) resistance is widespread throughout the Greater Mekong Subregion. This raises concern over the antimalarial treatment in Thailand since it shares borders with Cambodia, Laos, and Myanmar where high ACT failure rates were reported. It is crucial to have information about the spread of ACT resistance for efficient planning and treatment. This study was to identify the molecular markers for antimalarial drug resistance: Pfkelch13 and Pfmdr1 mutations from 5 provinces of southern Thailand, from 2012 to 2017, of which 2 provinces on the Thai- Myanmar border (Chumphon and Ranong), one on Thai-Malaysia border (Yala) and 2 from non-border provinces (Phang Nga and Surat Thani). The results showed that C580Y mutation of Pfkelch13 was found mainly in the province on the Thai-Myanmar border. No mutations in the PfKelch13 gene were found in Surat Thani and Yala. The Pfmdr1 gene isolated from the Thai-Malaysia border was a different pattern from those found in other areas (100% N86Y) whereas wild type strain was present in Phang Nga. Our study indicated that the molecular markers of artemisinin resistance were spread in the provinces bordering along the Thai-Myanmar, and the pattern of Pfmdr1 mutations from the areas along the international border of Thailand differed from those of the non-border provinces. The information of the molecular markers from this study highlighted the recent spread of artemisinin resistant parasites from the endemic area, and the data will be useful for optimizing antimalarial treatment based on regional differences.

Prevalence of intestinal parasitic infections and associated risk factors for hookworm infections among primary schoolchildren in rural areas of Nakhon Si Thammarat, southern Thailand.

BACKGROUND: Soil-transmitted helminth (STH) infections are among the most common type of infections worldwide and are widely distributed in tropical areas. In rural areas of southern Thailand where most land is used for agriculture, children are at risk of acquiring parasites, especially STHs. Assessing the current situation regarding parasitic infection in these areas is a prerequisite for developing appropriate control measures. This study is aimed at determining the prevalence of intestinal parasitic infections, the intensity of STH infections and the associated risk factors among primary schoolchildren in Nopphitam District, Nakhon Si Thammarat Province, Thailand. METHODS: A cross-sectional study involving 299 schoolchildren between 7 and 12 years of age was conducted between January and March 2016. A questionnaire administered by direct interviews was used to collect sociodemographic information and data on associated risk factors. Stool samples were processed using direct wet smears, formalin-ethyl acetate sedimentation concentration, and the modified Kato-Katz technique. RESULTS: The overall prevalence of intestinal parasites among the 299 children was 16% (48 of 299), with 32 children infected with hookworms (10.7%), 10 with Blastocystis hominis (3.3%), seven with Giardia intestinalis (1.6%), one with Enterobius vermicularis (0.3%), and one with Trichuris trichiura (0.3%). The hookworm infection intensity, measured by the median eggs per gram (EPG) of stool, was 1200 EPG (Interquartile range (IQR): 360-3200). Most children had light-intensity hookworm infections, but two had heavy-intensity infections. When participants included in the sample were classified by age, children 10-12 years old demonstrated higher intestinal parasite prevalence than those aged 7-9 years (adjusted odds ratio (AOR) = 2.3, 95% CI: 1.1-4.9, P = 0.030). Inadequate handwashing before meals was statistically associated with hookworm infections (AOR = 2.3; 95% CI: 1.1-4.8, P = 0.037). CONCLUSIONS: This study highlights that hookworms are the most prevalent STH infection in the study area. Older age group (10-12 years) and inadequate handwashing before meals were statistically associated with hookworm infections. Accordingly, appropriate strategies and education on personal and environmental hygiene should be implemented. Moreover, the cost-effectiveness of mass drug administration in this area should be further investigated.

Prevalence of Zoonotic Intestinal Parasites in Meat Goats in Southern Thailand.

Background: Intestinal parasites not only lead to poor goat health and productivity but can also affect human health. We investigated the distribution of zoonotic intestinal parasites among goats in southern Thailand to assess the human health risks. Materials and Methods: Overall, 561 fecal samples were collected randomly from goats in farms (55) in Songkhla, Satun, Pattalung, Pattani, Yala, and Narathiwat provinces between January 2020 to January 2022. Parasite eggs were detected via the standard protocol formalin ether concentration technique (FECT). Results: Samples containing one or more intestinal parasites accounted for 97.33% (543/561) of the total samples, and the percentage of zoonotic parasite was 80.04% (449/561). Among the positive samples, two types of zoonotic helminths were identified, Strongylid egg type (79.32%) and Fasciola spp. (2.14%). Strongylid egg type was highly abundant in samples from Satun (84.62%), Songkhla (82.74%), Pattalung (79.31%), and Yala (77.27%). Fasciola spp. was mostly found in samples form Pattalung (13.79%) and Songkhla (1.12%). Eimeria spp. was the mostly identified protozoa 25.67%. It was mostly identified in samples from Narathiwat (75%), Pattani (41.9%), and Songkhla (31.41%). Mixed infections accounted for 40.82% of the total with 33 patterns. It was found that Strongylid egg types occurred in 28 patterns (84.85%). Strongylid egg types-Eimeria spp.-pattern was the most commonly found. Conclusion: Based on the results, zoonotic helminth infection was found together with widespread and high diversity of intestinal parasites infection in meat goats, which affect animal health and may pose a risk to human health. Mass deworming programs with a proper anthelmintic drugs and good agricultural practices need to be encouraged by the government so that people who contact with goats should practice good hygiene behavior. Farm management should be applied by intensive goat raising with pasture circulating to reduce parasite egg contamination. Moreover, fresh fertilizers from goat faces should be avoided.

Epidemiological Profile of Ear, Nose, and Throat (ENT) Diseases in the Outpatient Department at Thung Song Hospital, a General Hospital in Southern Thailand, from 2016 to 2019.

The demand for ear, nose, and throat (ENT) care significantly contributes to the workload in outpatient departments (OPDs) worldwide, including Thailand. However, the epidemiology of ENT diseases in Thai OPDs has not been thoroughly reported. Therefore, this study aimed to assess and describe the epidemiology of these conditions among patients attending the ENT clinic at Thung Song Hospital, marking the first epidemiological report of southern Thailand. This retrospective, descriptive study spanned four years and observed the number of ENT patients. The comprehensive dataset revealed a total of 34,848 ENT visits and 12,712 new cases within the ENT clinic's OPD, averaging 3,178 case instances annually. Notably, over a quarter of the patients were classified as elderly, aged 60 years or older. Of significance, the prevalence of ENT diseases among females exceeded that of males by more than 15% each year. Specific age groups revealed distinct prevalent conditions: otitis externa was most common among children, benign tumors prevailed in adults, and sensorineural hearing loss was prominent among the elderly. This study endeavor aims to deepen the understanding of the epidemiology of these diseases. Such investigations could guide the refinement of healthcare approaches targeting ENT-related ailments.

The Impact of Public Holidays on Insurgent Attacks: The Case of Thailand.

This paper analyzes Malay-Muslim insurgents' attacks in the three southern provinces of Thailand between the years of 2010-2021 and identifies the role of public holidays on the level of violence. The existing literature suggests terrorists consider holidays during attack planning. However, there is a lack of agreement on the effect direction. Some studies have found that holidays are a force for peace while others have found they can act as trigger for more violence. Applying environmental criminology to the timing of terrorist attacks, we argue that the type of the holiday matters. Therefore, we analyze public (secular), Islamic, and Buddhist holidays separately. We show that Islamic holidays witness increased violence while Buddhist and public holidays see reductions. We discuss that Islamic holidays increase the Malay-Muslim insurgents' motivation to attack by assigning to those dates a higher symbolic value. On the other hand, on Buddhist and public holidays, insurgents may hesitate to attack to avoid the adverse effects of losing public support and triggering a backlash. The results demonstrate the necessity to analyze the temporal dynamics of terrorist attacks.

Factors associated with the worsening of COVID-19 symptoms among cohorts in community- or home-isolation care in southern Thailand.

Introduction: This study aimed to investigate factors associated with time-to-referral due to worsening symptoms in patients with laboratory-confirmed COVID-19 in southern Thailand. While underlying diseases have been evaluated to assess COVID-19 severity, the influence of vaccinations and treatments is also crucial. Methods: A cohort of 8,638 patients quarantined in home or community isolation with laboratory-confirmed COVID-19 was analyzed. Survival analysis and the Cox proportional hazard ratio were employed to assess factors influencing time-toreferral. Results: Age ≥ 60 years, neurologic disorders, cardiovascular disease, and human immunodeficiency virus infection were identified as significant risk factors for severe COVID-19 referral. Patients who received full- or booster-dose vaccinations had a lower risk of experiencing severe symptoms compared to unvaccinated patients. Notably, individuals vaccinated during the Omicron-dominant period had a substantially lower time-to-referral than those unvaccinated during the Delta-dominant period. Moreover, patients vaccinated between 1 and 6 months prior to infection had a significantly lower risk of time-to-referral than the reference group. Discussion: These findings demonstrate early intervention in high-risk COVID-19 patients and the importance of vaccination efficacy to reduce symptom severity. The study provides valuable insights for guiding future epidemic management strategies and optimising patient care during infectious disease outbreaks.

Under-Reporting Cases and Deaths from Melioidosis: A Retrospective Finding in Songkhla and Phatthalung Province of Southern Thailand, 2014-2020.

Melioidosis, caused by Burkholderia pseudomallei, is a notifiable disease associated with a high mortality rate in Thailand. The disease is highly endemic in northeast Thailand, while its prevalence in other parts of the country is poorly documented. This study aimed at improving the surveillance system for melioidosis in southern Thailand, where the disease was believed to be underreported. Two adjacent southern provinces, Songkhla and Phatthalung, were selected as the model provinces to study melioidosis. There were 473 individuals diagnosed with culture-confirmed melioidosis by clinical microbiology laboratories at four tertiary care hospitals in both provinces from January 2014 to December 2020. The median age was 54 years (IQR 41.5-64), 284 (60%) of the patients were adults ≥50 years of age, and 337 (71.2%) were male. We retrospectively analyzed 455 patients treated at either Songklanarind Hospital, Hatyai Hospital, Songkhla Provincial Hospital, or Phatthalung Provincial Hospital, of whom 181 (39.8%) patients died. The median duration from admission to death was five days (IQR 2-17). Of the 455 patients, 272 (57.5%) had at least one clinical risk factor, and 188 (39.8%) had diabetes. Two major clinical manifestations, bacteremia and pneumonia, occurred in 274 (58.1%) and 166 (35.2%) patients, respectively. In most cases, 298 (75%) out of 395 local patients were associated with rainfall. Over the seven years of the study, the average annual incidence was 2.87 cases per 100,000 population (95% CI, 2.10 to 3.64). This study has confirmed that these two provinces of southern Thailand are endemic to melioidosis; even though the incidence rate is much lower than that of the Northeast, the mortality rate is comparably high.

The changing composition of urinary calculi in Southern Thailand over the past 14 years.

Objective: A worldwide increased incidence of urolithiasis has been observed over the past few decades. Insight into the composition of these stones can lead to enhanced medical treatment and outcomes. The objective of this study was to examine the distribution and chemical composition of urinary calculi in Southern Thailand over the past decade. Materials and Methods: An analysis was conducted on 2611 urinary calculi submitted to the Stone Analysis Laboratory, Songklanagarind Hospital, a single stone analysis laboratory in Southern Thailand. The analysis was performed from 2007 to 2020 using Fourier-transform infrared spectroscopy. The demographic results were described using descriptive statistical analyses, and the Chi-square test for trends was performed to identify changes in urinary calculi composition. Results: The patients' demographic data revealed a male-to-female ratio of 2.2:1; the most common age group of affected men was 50-69 years, whereas the most common age group of affected women was 40-59 years. The most common components found in the calculi were uric acid (30.6%), mixed calcium oxalate with calcium phosphate (29.2%), and calcium oxalate (26.7%). We noted a trend of increasing uric acid calculi for 14 years (P = 0.00493), whereas the trend for the other major components was decreasing. Conclusion: The most common component of urinary calculi analyzed in Southern Thailand was uric acid, with a significant rising trend in proportion in the past decade; the trend of other major components, such as mixed calcium oxalate-calcium phosphate and calcium oxalate, decreased.

Species diversity of phlebotomine sand flies and sympatric occurrence of Leishmania (Mundinia) martiniquensis, Leishmania (Leishmania) donovani complex, and Trypanosoma spp. in the visceral leishmaniasis focus of southern Thailand.

Autochthonous leishmaniasis in Thailand has recently been a public health concern due to an increasing number of new clinical cases. Most indigenous cases were diagnosed with Leishmania (Mundinia) martiniquensis, and Leishmania (Mundinia) orientalis. However, some doubts regarding vector misidentification have arisen and need to be elucidated. Accordingly, we aimed to assess the species composition of sand flies and determine the molecular prevalence of trypanosomatids in the transmission area of leishmaniasis in southern Thailand. In the present study, a total of 569 sand flies were caught from the vicinity of a visceral leishmaniasis patient's house in Na Thawi District, Songkhla Province. Of these, 229 parous and gravid females consisted of Sergentomyia khawi, Se. barraudi, Phlebotomus stantoni, Grassomyia indica, and Se. hivernus, accounting for 31.4%, 30.6%, 29.7%, 7.9%, and 0.4%, respectively. However, Se. gemmea, which has previously been proposed as the most abundant species and putative vector of visceral leishmaniasis, was not found in the present study. Based on ITS1-PCR and sequence analysis, two specimens of Gr. indica and Ph. stantoni showed positive amplification of L. martiniquensis and L. donovani complex, respectively, the first one being presumed indigenous and the second one being not. Anuran Trypanosoma was also molecularly detected using SSU rRNA-PCR and ubiquitously found in 16 specimens of four dominant sand fly species except for Se. hivernus. The obtained sequences could be phylogenetically categorized into the two major amphibian clades (An04/Frog1 and An01+An02/Frog2). The existence of the monophyletic subgroup and distinct lineage suggests them as novel Trypanosoma species. The TCS network analysis of these anuran Trypanosoma sequences also revealed high haplotype diversity (Hd = 0.925 ± 0.050), but low nucleotide diversity (π = 0.019 ± 0.009). Furthermore, the living anuran trypanosomes were microscopically demonstrated in a single specimen of Gr. indica, supporting the vectorial capacity. Importantly, our data confirmed the scarcity of Se. gemmea and also uncovered, for the first time, the co-circulation of L. martiniquensis, L. donovani complex, and suspected novel anuran Trypanosoma spp. in phlebotomine sand files, implicating their potential role as vectors of trypanosomatid parasites. Therefore, the novel data from this study would greatly facilitate the comprehension of the complexity of trypanosomatid transmission and the establishment of prevention and control measures for this neglected disease more effectively.

First Evidence of Co-Circulation of Emerging Leishmania martiniquensis, Leishmania orientalis, and Crithidia sp. in Culicoides Biting Midges (Diptera: Ceratopogonidae), the Putative Vectors for Autochthonous Transmission in Southern Thailand.

Since 1996, autochthonous cases of emerging leishmaniasis caused by Leishmania (Mundinia) martiniquensis and Leishmania (Mundinia) orientalis have been more frequently reported, especially in the northern and southern parts of Thailand. However, the accurate identification of their natural vectors and reservoirs remains unconfirmed. Previous studies have suggested that these emerging parasites might be transmitted by other non-phlebotomine vectors. Herein, we speculated that Culicoides biting midges might act as the competent vectors responsible for autochthonous leishmaniasis in southern Thailand. In this research, 187 non-engorged, parous and gravid Culicoides females and 47 blood-engorged ones were trapped from the residences of two recently diagnosed visceral leishmaniasis patients in Sadao District and the unaffected site in Rattaphum District, Songkhla Province, southern Thailand. Species diversity and abundance of biting midges varied among the trapping sites. Using ITS1-PCR and BLASTn analysis, L. martiniquensis was predominantly detected in several Culicoides species, including C. peregrinus, C. oxystoma, C. mahasarakhamense, and C. huffi from the vicinity of patients' houses; and in C. fordae and C. fulvus from the unaffected site. L. orientalis was also co-circulated in C. peregrinus and C. oxystoma caught near the second patient's house. Additionally, Crithidia sp. were also detected using SSU rRNA-PCR across Culicoides spp. Host blood meal analysis of eight different Culicoides species from the unaffected site also revealed that all trapped Culicoides had fed on cows and goats, indicating the possible role of these mammalian species as reservoir hosts. Essentially, this study is the first entomological investigation, revealing the co-circulation of emerging trypanosomatids among several species of Culicoides biting midges and strongly supporting the potential role of this insect group as the main vectors responsible for the epidemiology of autochthonous leishmaniasis in southern Thailand.

Prevalence and Virulent Gene Profiles of Sorbitol Non-Fermenting Shiga Toxin-Producing Escherichia coli Isolated from Goats in Southern Thailand.

Shiga toxin-producing Escherichia coli (STEC) is the pathogenic E. coli causing disease in humans via the consumption or handling of animal food products. The high prevalence of these organisms in ruminants has been widely reported. Among STECs, O157 is one of the most lethal serotypes causing serious disease in humans. The present study investigated the prevalence of sorbitol non-fermenting STECs in goats reared in the lower region of southern Thailand and described the virulent factors carried by those isolates. Sorbitol non-fermenting (SNF)-STECs were found in 57 out of 646 goats (8.82%; 95% CI 6.75% to 11.28%). Molecular identification revealed that 0.77% of SNF-STEC isolates were the O157 serotype. Shiga toxin genes (stx1 and stx2) and other virulent genes (i.e., eaeA, ehxA, and saa) were detected by molecular techniques. The presence of stx1 (75.44%) was significantly higher than that of stx2 (22.81%), whereas 1.75% of the total isolates carried both stx1 and stx2. Most of the isolates carried ehxA for 75.44%, followed by saa (42.11%) and eaeA (12.28%). In addition, 21.05% of STEC isolates did not carry any eaeA, ehxA, or saa. The first investigation on SNF-STECs in goat was conducted in the lower region of southern Thailand. The present study revealed that goats could be one of the potential carriers of SNF-STECs in the observing area.

"Ya Luk Ka Tan Yoo": An Ethnography of Filial Piety Culture, Medication Usage, and Health Perceptions of the Elderly in Rural Southern Thailand.

Filial piety is a Buddhist virtue, and its meaning varies across cultures. In Thailand, filial piety refers to an appreciation of one's indebtedness to others. Previous studies showed that filial piety is deeply grounded in longstanding culture values and related to the health of the elderly. Information from some literature revealed that medicinal products given to the elderly by their children, called "Ya-Luk-Ka-Tan-Yoo", were apparent in the communities of rural southern Thailand. This study aims to explore in depth how "Ya-Luk-Ka-Tan-Yoo" is perceived, valued, and functions in southern Thailand's socio-cultural contexts. Ethnography methodology is used, and a researcher was embedded in the field for six months, gathering data through participant observation and ethno-graphic interviews with fifty-two respondents. The findings reveal that filial piety medication is related to the local meanings of medicine, children, and gratitude. "Ya-Luk-Ka-Tan-Yoo," in the eyes of both the elderly and their children, encompasses more than just health. Implicit herein are the concepts of a means of care and gratitude and a symbol of life. Filial piety medication is thus a carrier/medium of physical, financial, and emotional support. This research reveals how the ill health of the elderly is transformed to a commodity. Nonetheless, the negative impact of the efficacy of filial piety medication remains an issue of concern among professionals. The findings indicate that people are aware of the risks associated with self-medication. However, they insisted that their use was still necessary and justifiable.

Development of a High Resolution Melting Curve Analysis for the Detection of Hemoglobin δ-Chain Variants in Thailand and Identification of Hb A2-Walsgrave [codon 52 (GAT>CAT), Asp→His; HBD:c.157G>C] in a Pregnant Woman from Southern Thailand.

Background: Delta-chain (δ-chain) variants are a group of rare hemoglobin (Hb) variants resulting from mutations within the δ-globin gene. Although quantification of Hb A2 levels is a useful screening tool for the beta-thalassemia trait, the coinheritance of a δ-globin gene mutation can lead to misinterpretation of diagnostic results. Objective: To identify an unreported Hb A2 variant in Thailand and to develop a high resolution melting (HRM) curve assay for the four δ-globin chain variants found in the Thai population. Materials and Methods: Allele-specific polymerase chain reaction (ASPCR) was used to analyze a total of 18 DNA samples for Hb variants comprising 10 wild-type controls, 4 Hb A2-Melbourne, 1 Hb A2-Lampang, 2 Hb A2-Kiriwong, and an unknown variant via HRM assays. Results: The unreported Hb A2 variant in Thailand was found to be Hb A2-Walsgrave resulting from δ-globin gene mutation at codon 52 (GAT>CAT). This was also confirmed using ASPCR. In addition, we demonstrated that the HRM curve profile for Hb A2-Melbourne, Hb A2-Lampang, Hb A2-Walsgrave, and Hb A2-Kiriwong could be identified so as to distinguish the mutant alleles from one another and from wild-type alleles. Conclusion: This HRM assay detected both known and unknown mutations with simultaneous differentiation between heterozygous and homozygous alleles on a polymerase chain reaction fragment spanning four of the δ-globin variants found in Thailand. This assay may help to support the prevention and control of thalassemias and hemoglobinopathies in Thailand.

Hematological profile of blood parasitic infected dogs in Southern Thailand.

BACKGROUND AND AIM: Tick-borne pathogens such as Babesia canis, Hepatozoon canis, and Ehrlichia canis can cause serious disease in canines. Each blood parasite can be associated with different hematological characteristics in infected dogs. Identification of hematological alterations during routine laboratory screening of blood samples from dogs displaying clinical signs is essential for diagnosing blood parasitic infections. This study aimed to evaluate parasitic infections and hematological alterations in blood samples of infected dogs in Southern Thailand. MATERIALS AND METHODS: A total of 474 blood samples were collected from dogs presented at the Veterinary Teaching Hospital of the Prince of Songkla University between 2016 and 2019. An automatic hematology analyzer was used to establish hematological values; peripheral blood films were screened for blood parasites and their detection was associated with hematological alterations to determine the odds ratio (OR). RESULTS: This study found that E. canis (n=127) was the most common blood parasite infecting dogs in southern Thailand, followed by H. canis (n=100) and B. canis (n=24). Hematological alterations caused by Ehrlichia infections included anemia, thrombocytopenia, monocytosis, and eosinophilia (OR=14.64, 17.63, 20.34, and 13.43, respectively; p<0.01). The blood samples of Hepatozoon-infected dogs were characterized by anemia, thrombocytopenia, leukocytosis, neutrophilia, and monocytosis (OR=6.35, 3.16, 12.80, 11.11, and 17.37, respectively; p<0.01). Anemia, thrombocytopenia, eosinopenia, and lymphopenia (OR=10.09, 33.00, 20.02, and 66.47 respectively; p<0.01) were associated with B. canis-infected dogs. CONCLUSION: These data support the fact that hematological abnormalities are a hallmark for the identification of tick-borne infections. The hematological values, hereby reported, can be used as a guideline for the clinical diagnosis of canine blood parasitic infections in Southern Thailand.

A Pilot Study of Antibiotic Regimens for Infections Caused by Acinetobacter baumannii in a Secondary Hospital in Thailand.

PURPOSE: This retrospective pilot study aimed to investigate the antibiotic regimens used to treat Acinetobacter baumannii infections at a secondary hospital in southern Thailand. Additionally, the clinical outcomes and mortality of each regimen are described. PATIENTS AND METHODS: The medical charts of all patients admitted to Phang-Nga Hospital, Thailand, between 1 January 2019 and 31 May 2020 due to Acinetobacter baumannii infection were reviewed. Data were collected on the antibiotics that patients received before and after sensitivity testing, along with the clinical cure, mortality rates, and nephrotoxicity. RESULTS: Of the 32 inpatients recruited in the study, the most prescribed antibiotic regimen for empirical therapy was beta-lactam/beta-lactamase inhibitor monotherapy (22%), and for definitive therapy was meropenem monotherapy (28%). Combination therapy with two, three, or four antibiotics was prescribed less than 50% of cases for both empirical and definitive therapy. Moreover, the results indicated that patients receiving combination therapy had a lower clinical response and higher mortality than those receiving monotherapy. Furthermore, regimens containing colistin did not provide a higher clinical cure compared to those without colistin. CONCLUSION: The results of this pilot study support the use of monotherapy antibiotic regimens, including ceftazidime and meropenem, for the treatment of Acinetobacter baumannii infections in secondary hospitals. However, as these results are from a single hospital with limited number of patients, the application of the results should be done carefully. More patient data from other hospitals will be collected in the next phase of this study.

Prevalence of Enterobius vermicularis infections and associated risk factors among schoolchildren in Nakhon Si Thammarat, Thailand.

BACKGROUND: Enterobius vermicularis infection is an important public health problem worldwide, especially among schoolchildren in tropical and subtropical countries. The prevalence of E. vermicularis infections varies in each region of Thailand; however, its status remains unknown among children who live in rural areas of the southern region. This study aimed to evaluate the current prevalence of E. vermicularis infections and to identify the risk factors for infection among schoolchildren who live in rural communities in Nakhon Si Thammarat, Southern Thailand. RESULTS: The overall prevalence of E. vermicularis infections was 5.79% (23 of 397). According to a multivariate analysis, the following were found to be risk factors associated with E. vermicularis infections (P < 0.05): those of the male sex (AOR = 4.03, 95% CI 1.22-13.29), those in the 3-6 year age group (AOR = 4.85, 95% CI 1.51-15.59), those who have a mother with a primary school education level (AOR = 11.22, 95% CI 1.75-71.77), those who have older sibling(s) (AOR = 6.25, 95% CI 1.83-21.26), those who have younger sibling(s) (AOR = 6.24, 95% CI 2.00-19.44), those who sometimes wash their hands after using the toilet (AOR = 5.25, 95% CI 1.24-22.21), those who keep their fingernails long (AOR = 29.97, 95% CI 6.16-145.85), and those who suck their fingers (AOR = 3.59, 95% CI 1.21-10.66). CONCLUSIONS: This was the first report that revealed the prevalence of E. vermicularis infections among children who live in rural areas of Southern Thailand through detection using the Scotch tape technique. This study demonstrated that the high prevalence of E. vermicularis infections in schoolchildren with siblings was a significant independent predictor and that the transmission of this infection may occur in the family through their school-age siblings. In addition, children who have poor personal hygiene have a high prevalence of E. vermicularis infections. Therefore, maintaining good handwashing habits, keeping one's fingernails short, and avoiding sucking one's fingers should be important preventive measures against infection. Moreover, health literacy or health education, especially for parents or the principal caretakers of children, should be implemented to reduce E. vermicularis infections.