plueme/wizJson huggingface dataset:
This quasi-experimental research aimed to determine effects of campaign using change agent team and mass media for promotion of Antibiotic Smart Use (ASU) concept and new social norm towards ASU. A correlation between social norm and ASU behaviors was also examined. The sample was 624 subjects, 348 were assigned to the intervention group, and 276 to the control group. The interintervention group was implemented with a campaign using change agent team and mass media aimed at promotion of ASU concept and new social norm. Paired t-test was used to compare social norm and ASU behaviors between baseline data and after the campaign implementation. An independent t-test was used to compare those between the intervention and control groups. Results at the end of the campaign implementation demonstrated that social norm in the intervention group was significantly higher than the baseline data, but no significant difference in social norm was found between the intervention and control groups. With regard to ASU behaviors, there was significant improvement in ASU behaviors after the campaign implementation in the intervention group. A Significant difference was also found for ASU behaviors between the intervention and control groups after the campaign implementation. In addition, this study demonstrated that changes in social norm towards ASU were significantly correlated with changes in ASU behavior.
Antibiotics Smart Use (ASU) was introduced in 2007 by Thai Food and Drug Administration. Its goal was to create new social norm on rational use of antibiotics in Thailand. Qualitative research was used to investigate factors for sustainability of the ASU. Semi-structured interviews were conducted with 39 key informants (30 projects, 18 provinces) between January 21 and March 28, 2013 (2 months). Content analysis was used. The key informants were purposively selected from health care professionals who experienced the ASU as a coordinator, supporter, promoter and driver at least one year.
Results show that key factors that affect the start up of ASU and sustainability in the organizations include policy support, institutionalization, leadership support, staff involvement, partnership, community participation, public behavior on antibiotics use, and program monitoring and evaluation. These findings will be useful for decision makers, program managers and program evaluators for driving the ASU to achieve the goal.
Background: Contact investigation (CI) reduces tuberculosis (TB) burden. Yet, implementing CI is still low. One of CI Barriers is health workers’ knowledge and attitude about TB. Design/Methods: Mixed-methods. A focus group discussion with doctors and nurses who had TB was conducted. A self-administered questionnaire was distributed to 60 doctors and 178 nurses. The questionnaire measured TB knowledge, stigma and CI practice. A stepwise multiple regression analysis was employed. Results: Response rate was 100%. Almost 20% of doctors and about 14% of nurses prefer a job without exposure to TB patients. Female doctors practiced CI 2.07 scores more than male doctors (95%CI 0.21, 3.92). The internists and the pediatricians had less CI scores than the resident doctors, respectively, 3.82 scores (95%CI -6.04, -1.60) and 0.17 scores (95%CI -2.51, 2.17). For nurses, an additional one year working experience increased 0.09 CI scores (95%CI 0.01, 0.17). Nurses obtaining TB training had 2.52 CI scores more than nurses without training (95%CI 0.99, 4.05). All household contacts of doctors and nurses having TB received TB screening. But contacts at the workplace (colleagues and patients) were not systematically investigated. Conclusions: TB training may increase CI practice in nurses. Annual health check for doctors and nurses should be reinforced. When doctors and nurses have TB, their contacts in the workplaces (co-workers and patients) should receive CI.
Transmission of tuberculosis (TB) has a negative impact on patients, personnel and hospitals.
This descriptive study aimed to determine implementation, obstacles and supporting needs of Thai
hospitals in preventing TB transmission. Data were collected by using self-administered questionnaire
developed by the researchers from the Guidelines for Preventing the Transmission of Mycobacterium
tuberculosis in Health-Care Settings 2005 of the US Centers for Disease Control and Prevention.
The questionnaire was sent to an infection control nurse of 524 hospitals, including 93 regional and
general government hospitals, 316 community hospitals randomly selected from 45% of all community
government hospitals, 8 university government hospitals, 33 other government hospitals and 74
private hospitals randomly selected from 111 private hospitals with 100 beds and more in all regions
of the country. The study was conducted during May to September 2009. The response rate was
72.5%.
The study results revealed that 93.6%, 73.9% and 47.3% of hospitals have implemented
measures of respiratory tract disease prevention, administrative controls, and environmental controls,
respectively. The most important obstacle in preventing TB transmission in hospitals was an
insufficient number of isolation rooms (80.2%), other obstacles were having an inappropriate area to
conduct the physical examination for TB patients (51.8%) and insufficient time for screening suspected
TB patients (50.2%). Most hospitals needed technical support for their ventilation system (86.3%),
training for personnel in charge of TB patients (76.8%), guidelines for preventing TB transmission in
hospitals (71.3%), guidelines for screening TB patients in the outpatient department (69.7%) and
screening forms for TB patients (60.2%).
Relevant organization should provide guidelines for preventing TB transmission, including guideline
for educating hospital personnel on caring for TB patients and preventing TB transmission for
every hospital and support expert consultation on hospital environment, especially ventilation
system, so that the hospitals can prevent TB transmission efficiently.
Burkholderia pseudomallei is a causative agent of melioidosis. Ceftazidime is a drug of choice
for treatment of this infection but the mortality rate is high in some endemic areas. This study investigates
the effectiveness of antibiotics by an in vitro antimicrobial susceptibility test. A total of
1,340 B. pseudomallei samples were isolated from patients admitted to Sappasitthiprasong Hospital,
Sisaket Hospital, and Amnatcharoen Hospital between January 2013 and February 2015. Antimicrobial
susceptibility of B. pseudomallei were evaluated by the standard disk diffusion test and to determine
minimum inhibitory concentration (MIC). Ceftazidime, imipenem, trimethoprim+sulfamethoxazole,
and ciprofloxacin were used as antimicrobial agents for the standard disk diffusion test, and MIC was
determined for ceftazidime, imipenem, and trimethoprim+sulfamethoxazole. Bacteria strains were
randomly selected for conventional polymerase chain reaction (PCR) followed by gel electrophoresis
analysis for penA and oxa gene.
Results demonstrated that all the antimicrobial agents were effective against B. pseudomallei.
Trimethoprim+sulfamethoxazole was 100% effective, and ceftazidime and imipenem were 98.36%
and 99.10% effective respectively. Ceftazidime MIC was 0.25 to ≥32 mg/ml and imipenem MIC was ≤0.5
to 16 mg/ml. It was found that 1.27% of B. pseudomallei was resistant to ceftazidime and 0.37% was
resistant to imipenem. All random samples found oxa gene but not penA gene.
It was concluded that all antimicrobial agents tested effective. Ceftazidime and imipenem were
bactericidal drugs of choice for melioidosis treatment. The bacteriostatic agent for B. pseudomallei
was trimethoprim+sulfamethoxazole. Although, the activity of the antimicrobial agents was effective
in vitro, early diagnostic and prompt clinical treatment to which drugs be administered intravenously
still urgently needed.
Antimicrobial resistance (AMR) is one of the most serious health threats worldwide, including Thailand. It has been estimated that failing to tackle AMR will result in up to 10 million deaths a year, a 3.8% decrease in Gross Domestic Product (GDP) and the world economy losses of US$100 trillion by 2050. Irrational drug use is a major cause of AMR and the factor associated with irrational use of drugs includes incorrect and inappropriate use of medicines. In addition, Thailand has developed the National Strategic Plan on Antimicrobial Resistance 2017-2021 (NSP-AMR). One of the five goals of NSPAMR is to increase 20% of public knowledge and awareness on control of AMR bacteria and appropriate use of antimicrobials. In order to monitor public awareness on AMR (Goal 4), it is important to design method to obtain baseline data to benchmark changes after the NSP-AMR implementation. National Statistical Office (NSO) has conducted the biannual Health and Welfare Survey (HWS) and the most current was in 2017 to incorporate the AMR module, a modified version of the Eurobarometer 445 reviewed by International Health Policy Program (IHPP) under Thailand’s Ministry of Public Health (MOPH). The key indicators such as knowledge about antibiotics, exposures to message on AMR and rational use of antibiotics would be generated. The integration of AMR module into HWS 2017 was achieved because of the rising concern on AMR at global and national level, linkage to NSP goals and the cooperation between NSO and IHPP, in order to generate baseline data among the population in Thailand. This would contribute to the monitoring of progress on the goal of NSP-AMR.
Introduction: Zika virus infection and its consequences have become increasingly concerned
recently. As a member of Flaviviruses, zika virus shares some clinical dengue fever manifestations. The
actual burden of zika virus infection in Thailand is unclear, and could be underestimated due to nonspecific
clinical pictures and the diagnostic testing has not been routinely available. We aim to study
the zika incidence among the suspected dengue fever patients. Methodology: From December 2016
to August 2017, adult and children who had clinical diagnosis of dengue fever at Bamrasnaradura Infectious
Diseases Institute were prospectively enrolled. After informed consent, a urine sample would
be collected for zika molecular testing by polymerase chain reaction (PCR). At 2 weeks later, a blood
sample was collected for zika and dengue serologic tests by ELISA. Results: A total of 73 suspected
dengue fever patients were enrolled; 64 were hospitalized, 46 cases were children (< 15 years of age).
The ratio of children to adult was 1.7:1. There were 3 confirmed zika-infected cases by urine PCR, a
4.1% incidence. All were adult treated as outpatients. The cases were found during June–August. All 3
cases had positive anti zika IgG (mean titer of 4.43 unit, range: 2.6-6.9 unit), but anti-zika IgM was found
to be positive (titer 2.9 unit), indeterminate (titer 0.9 unit) and negative (0.4 unit), one case each. All
had negative anti-dengue IgG or IgM titer. Conclusions: The patients presented with dengue fever may
actually had zika infection, although at low rate. The anti-zika IgM was not useful in making diagnosis.
High risk group such as pregnant women who presented with dengue fever should be tested for zika
infection.
Humans and companion dogs have directly been in close contacts which may pose an important
risk of transmitting pathogens and infections. The domestic animals may contribute to antimicrobial
resistance problem because antimicrobial resistant bacteria and antimicrobial resistant genes were increasingly
found in pets. Thus, the aim of this study was to survey fecal carriage of antimicrobial resistant
bacteria in dogs resided in the central region of Thailand. The rectal swabs were taken from 100 apparently
healthy dogs (50 stray dogs and 50 household dogs) for bacterial cultures and antibiotic susceptibility
testing. The results revealed that an overall prevalence of extended-spectrum beta-lactamase (ESBL)-
producing Enterobacteriaceae in dogs was 35%. ESBL-producing Enterobacteriaceae in fecal carriage
in the stray dog samples (62%) was significantly more than the household dog samples (8%), (p<0.001).
Methicillin-resistant Staphylococcus aureus was also isolated from a household dog. Escherichia coli
isolated from the household dogs tended to be more resistant to some antibiotics than those from the
stray dogs. These observations imply that the dogs resided in the central region of Thailand are also the
reservoir of antimicrobial resistant bacteria.
This study has been conducted under the Thai Surveillance of Antimicrobial Consumption which
is an official partnership program between Department of Agriculture (DOA), Department of Livestock
Development (DLD), Department of Fishery (DOF), Food and Drug Administration (FDA), Department
of Medical Sciences (DMSC), International Health Policy Program (IHPP), Ministry of Public Health, and
Kasetsart University. The study aims to (1) review measures used to control antimicrobial use in plant
agriculture in developed countries including registration of antimicrobials for plants, list of approved
antimicrobials for plants, relevant authority agencies, regulations, and surveillance system for antimicrobial
use in plants, and (2) to explain the current situation in Thailand regarding the control of
antimicrobial use in plants. The results of this study can contribute to the development of effective
surveillance system for antimicrobial consumption in plants and all living things.
In the United States, the U.S. Environmental Protection Agency (U.S.EPA) has approved three
antimicrobials for using in plants, namely streptomycin, oxytetracycline, and kasugamycin. In addition,
there is the national program under the United States Department of Agriculture (USDA) that
takes part in the surveillance of antimicrobial use in plants. In Thailand, antimicrobials are used to
control plant diseases caused by bacterial infection, for example, Greening or Huanglongbing disease
in mandarins. Since there is no antimicrobial registered for plant agriculture, farmers then used the
antimicrobials registered for human use on plant. So far, the attempt to control and monitor antimicrobial
consumption in Thailand is limited to certain some antimicrobials for human use. There is
neither surveillance system for antimicrobial use in plants nor development plan to increase capacity of
relevant personnel and laboratories in order to detect residual antimicrobials and antimicrobial
resistant bacteria contaminated in the environment. Hence, the development of the surveillance
system for antimicrobial use in plants and capacity building for personnel and laboratories are the
important areas for further studies in order to control environmental contamination from antimicrobials.
Antimicrobial resistance (AMR) is one of the most serious health threats worldwide and it has
become more intense to day-to-day concerns. Excessive and inappropriate uses of antimicrobial are
main drivers of the emergence of resistant bacterial strains. To optimize use of antimicrobial agents in
human and animal, as recommended by the Global Action Plan on AMR, countries need to develop
and sustain the system which monitors antimicrobial consumption in human and animal and disseminate
for policy decision. Hence, national surveillance of antimicrobial consumption is an important
tool to provide these useful evidences to policy makers and relevant AMR agencies on antimicrobial
consumption in humans and animals and its distribution at the national level.
The objective of this paper is to review surveillance systems of antimicrobial consumption in
European countries and to explore the possibility of establishment of the Thai Surveillance of Antimicrobial
Consumption (Thai-SAC) in humans and animals. Developed countries, including European
countries have institutionalized capacities to sustain SAC system and ensure policy uses. In Thailand,
with the application of experiences and guidelines from the European SAC and European Surveillance
of Veterinary Antimicrobial Consumption, the national SAC covering human and animal sector
consumptions are in development process by the Thai working group consisting of multi-sectoral,
multi-disciplinary researchers and key stakeholders particularly the Thai Food and Drug Administration.
In human sector, the current estimate of human medicine consumption including antibiotics in
monetary value does not provide data on the volume of consumption hence unable to monitor the
use of antibiotics and benchmark with other countries in particular European countries. The challenges
for Thai-SAC include law and enforcement on antimicrobial regulation, and the relevant database of
antimicrobial consumption in human and animal populations in Thailand.
The scoping review found no published research in the past decade that was focused on tuberculosis
surveillance in migrant labors in Thailand. The review data comparing the number of tuberculosis
patients in Thailand from three sources: the World Health Organization and two of the Ministry of
Public Health - the Permanent Secretary Office’s Information and Communication Technology Center
and the Department of Disease Control’s Bureau of Tuberculosis; indicated large disparities in terms
of both the number of migrant labors and the number of migrant labor tuberculosis cases in Thailand.
The chest X-ray screening for tuberculosis in migrant labors used by the Department of Employment of Thailand was in accordance with the tuberculosis screening guidelines of most Western and Asian
countries such as Singapore and Taiwan. The difference of tuberculosis screening processes was that
Western nations usually required pre-arrival screening from the country of origin of immigrants. Meanwhile,
migrant labors entered Thailand’s territory before any tuberculosis screening had been done.
The screening was then done after labor registration which might hinder the tuberculosis screening
process in the country. Singapore and Taiwan implemented time limits as to when the tuberculosis
screening would have to take place for migrant workers after arrival. The other countries also
screened to identify latent tuberculosis in vulnerable and high-risk groups. Major barriers of tuberculosis
monitoring in migrant labors in Thailand were the frequent relocating of labors and changes of
employment that made it difficult for the authorities to screen, monitor and treat tuberculosis in this
population as well as impeded the tuberculosis control efforts of public health agencies. The search
and review of information identified opportunities for improving tuberculosis management by enhancing
the efficiency of the tuberculosis surveillance in migrant labors in terms of coverage and quality
of health data.
Overexpression of human papillomavirus (HPV) 16 oncogenic protein E6 and hypermethylation of HPV16 L1 gene are of interest as biomarkers for cervical cancer progression. Immunochromatography (IC) and enzyme-linked immunosorbent assay (ELISA) are widely used to detect target biomolecules in human. In this study, we developed IC and ELISA assays to detect viral oncoprotein E6 and L1 gene methylation of HPV16 in cervical cells, respectively. The conjugated gold coated with protein G and mouse monoclonal anti-HPV16E6+HPV18E6 was optimized and can detect as low as 312.5 nanogram of HPV16 E6 purified protein using 0.5 microgram of antibody to E6 coated on strip in phosphate Buffer/0.05% Tween 20/1% BSA, pH 7.4 as running buffer. Positive band can also be detected in protein extraction from cervical cell lines containing HPV16 at least 1x105 cells. Nonspecific band was not detected when other types of HPV positive cell line and HPV negative cell line as well as bacterial cell lysate were used in the assay. The remaining cervical cells samples obtained from routine laboratory were used to evaluate the performance of the developed assay. HPV negative samples or other high-risk HPV types other than HPV16 and 18 showed negative results. HPV16 positive samples showed 40%, 22.22%, 50%, 28.6% and 18.18% positive results by IC in squamous cell carcinoma, CIN3, CIN2, CIN1 and inflammation/ASCUS groups, respectively. HPV16 L1 gene methylation status was first detected using bisulfite treated DNA and pyrosequencing assay was used for quantification of methylation. Hypermethylation was detected in cervical cancer but was low in normal/CIN1 lesions. CpG sites 5600 and 5609 are highly methylated compared to other CpGs. Indirect and sandwich ELISA were developed to detect HPV16 L1 gene methylation status using specific oligonucleotide probe for HPV16, however, it was not successful in developing sandwich ELISA assay. Indirect ELISA showed high background when oligonucleotide probe was present with other reagents in the absent of HPV16 positive DNA. Other system without oligonucleotide probe in the present of all reagents revealed low background. Optimization of blocking reagents, oligonucleotide probe concentration, streptavidin concentration, anti-5-methylcytosine dilution and incubation time were not successfully reduced the background. The ELISA assay was not yet developed successfully, however, troubleshooting will be further performed to reduce the background and can be further tested for specificity and sensitivity and will be applied in clinical samples
This mixed method research aims to conduct 1) the situation analysis of Routine to Research (R2R) research among the 11th and the 12th regional health level and the support from researchers, facilitators, and administrators for research utilization, 2) the process of transformative learning by learning organization components among R2R researchers, and 3) the implementing of R2R research into practice for clients, organizations, and social by using six building block components. Data collection consisted of: 1) R2R research conducting among the 11th and the 12th regional health level between 2551-2559 BE and 2) the focus group of 88 R2R researchers, facilitators, and administrators between December 2559 BE to November 2560 BE. Quantitative data was analyzed by using frequency and percentage. Qualitative data was analyzed by using content analysis. Results revealed that: 1) there were 415 R2R research conducting among the 11th and the 12th regional health level between 2552-2559 BE. The number of R2R research among the 11th and the 12th regional health level was increasing from 2552 BE to 2559 BE but the number of the 12th regional health level R2R research was 3 times more than the number of the 11th regional health level R2R research. However, most of R2R research still lacked of research utilization. The regional health level administrators supported R2R research by issuing R2R research policy, setting R2R research responsibility personnel, appointing R2R research board, supporting the use of technology and social media for knowledge sharing and research publication both at provincial level and regional health level. 2) R2R researchers leaned and transformed themselves by system thinking, mental model, personal mastery, shared vision and team learning. 3) R2R research was utilized the most in health system services by improving health service system such as eliminating unnecessary health service steps, decreasing number of clients, decreasing cost of care, and promoting patient safety.