plueme/wizJson huggingface dataset:
This research aims to develop the village health volunteers (VHVs) and community participation for prevention and surveillance of Covid19 infection by using the geographic information system (GIS) to the policy option for promoting the VHV’s role in strengthening community on Covid19 screening. The participatory action research was introduced to study in 2 districts in Nakhon sawan province and divided into 2 phases: 1) A model development for promoting the VHVs and community involvement on prevention and surveillance of the Covid19 by using the GIS and 2) Evaluation the model effectiveness and synthesis the policy options. Samples were community dwellers, VHVs, health personnel in subdistrict health promotion hospital (SDHPC) or primary care unit (PCU), subdistrict health boards (SDHB), provincial health administrators, and academic officers. Tools were questionnaires, interview guidelines, focus group guidelines, and GIS. Data analysis employed content analysis for qualitative data and percent, mean, and standard deviation for quantitative data. The results show that: 1) the model of VHV and community involvement for prevention and surveillance of the Covid19 infection was composed of the method of promoting the VHV and community involvement and the activities of prevention and surveillance the Covid19. 2) The GIS as a tool for prevention and surveillance of the Covid19 infection called “EpiScanCovid19”. It worked on the internet and composed of 2 application: Mini application on a smartphone (for VHV collect data, analyze the individual risk, health education, and situation report) and Web application on the computer (for health personnel or health board review the risk situation and monitor the VHV’s work). 3) the effectiveness showed VHVs perceived the risks, educated their community member, timely report events to SDHPC or PCU, and health personnel frequently monitor the VHV activity. They were satisfied with the application at a good level and over about 85%. The outcomes were early detection of the contact cases and rapid control of the spread. 4) the policy options were promoting the VHV and community involvement for active surveillance by using EpiScanCovid19 application, training for building the data management capacity of health personnel, providing the specific area or local quarantine, and supporting the expenditure of community-based surveillance and disease prevention by using this application especially the internet charge. Community-based surveillance and prevention by using the EpiScanCovid19 application were necessary interventions on waning the Covid19 infection spread. It was a health services and their network challenge for promoting the continuing and suggesting for applications in all areas or especially pandemic area. It is a good opportunity for people if this model is applied for non-communicable diseases or other infectious diseases.
Dengue fever and its severe form, dengue hemorrhagic fever (DHF) and dengue shock syndrome are one of the most important mosquito-borne tropical disease. The severe form of dengue disease was hypothesized to be correlated with high viral titer and secondary infection with heterologous serotypes, so called ADE, that caused mostly by anti-Envelop (E) and anti-premembrane (prM) antibodies. However, anti-non-structural 1 (NS1) antibodies was recently interested as one factor for severe dengue infection because of their cross-reactivity with human molecules such as plasminogen, thrombin and endothelial cells, causing some severe symptoms like vascular leakage. However, anti-NS1 antibody was also proved from several studies for their protective activity in vitro and in vivo. To clearly identify the important role of anti-NS1 human antibody, both for dengue pathogenesis and therapeutic, in this study, twelve anti-dengue NS1 human monoclonal antibodies were characterized. Cross-reactivity of those HuMAbs with human molecules, plasminogen, thrombin, and endothelial cell, were determined. Activation of plasmin formation were also investigated. Their viral replication inhibition activity in human microvascular endothelial cell (HMEC-1) were tested in some HuMAbs, which showed and not showed crossreactivity with human molecules. It was shown that all 12 anti-NS1 HuMAbs were cross-reacted with plasminogen, but not with thrombin. Among them, one HuMAbs could not activated plasminogen to plasmin. Some of them showed cross-reactivity with endothelial cell. Fortunately, it was found that one clones that is unable to activate plasminogen, could inhibit viral replication in vitro. Moreover, from epitope mapping with truncated NS1, all anti-HuMAbs were targeted to 301-352 of dengue NS1 protein. This is the first study described the generation and characterization of full IgG human monoclonal antibody specific to NS1 protein of Dengue virus. After thoroughly characterization, the mechanism how anti-NS1 HuMAbs play a role on dengue pathogenesis can be enlighten. Also, the promising role of anti-NS1 as a therapeutic candidates can be shown.
Thailand has “the National List of Essential Medicines (NLEM)” as an important tool of the drug
system. It is a referenced pharmaceutical benefit package of the public health insurance systems of
accessing to essential medicines. This retrospective review aimed to review access to high-cost essential
medicines through a drug selection process of subcategory E (2) during 2007-2019, to analyze the developments
of drug selection process including stakeholders, and to provide suggestions to stakeholders
further developments of the NLEM process. The results found that the subcategory E (2) process enhanced
access to high-cost essential medicines through the drug selection process developed and designed
specifically for subcategory E (2). The guideline for regulating drug use and the process of determining
the affordability and the budget capacity were included to subcategory E (2) selection process. Despite
stricter control in drug use and reimbursement of subcategory E (2) compared to other subcategories,
many challenges were found. Drug items and indications listed under the subcategory E (2) have been
increased with an annual increase of budget. However, the monitoring and evaluation (M&E) of drug use
in subcategory E (2) were lacking. Therefore, it is important to suggest development of the national M&E
system to be beneficial for policy decision making of access to high-cost essential medicines through the
drug selection process of the NLEM.
Monitoring and evaluation (M&E) is one of crucial functions in the national drug policy. Performance
indicators ensure that priority actions are successfully implemented and produce desirable outcomes.
Performance indicators should have clarity, usefulness, measurability, reliability, and validity as well as
gain acceptance by key stakeholders. It is observed that international M&E frameworks and those existed
in Thailand applied common concepts and gave priority to similar components of drug systems. In Thailand,
the Thai Drug Watch has once developed 7-dimension drug systems indicators, namely governance,
self-reliance, safety, equity, drug quality, accessibility and affordability, and rational use, and analyzed
the situation in 2009. Nonetheless, they have not been routinely monitored ever since. Hence, definitive
and widely agreed indicators are still lacking apart from the Sustainable Development Goal indicator 3.b,
which supports the research and development of vaccines and medicines for the communicable and
non-communicable diseases that primarily affect developing countries and provides access to affordable
essential medicines and vaccines for all. SDG 3.b.3 monitors the proportion of health facilities that have
a core set of relevant essential medicines available and affordable on a sustainable basis. The indicators
developed and prioritized by the World Health Organization have potentials to be adapted to the
Thailand drug system contexts. The National Drug Policy group of the Food and Drug Administration has
institutional responsibility to develop and monitor the drug system performance; for which information
systems play an important supporting role.
The National Health Security Act 2002 provides health coverage to only “Thai citizens”. The new
universal coverage scheme (UCS) in 2002 deprived people with citizenship problem (mainly stateless
minority around 700,000) of the previous coverage under the low income card scheme. In the past five
years, many attempts from stakeholders were carried out to solve this issue. Eventually, the people with
citizenship problem scheme (PCPS) was approved by the cabinet in 2010 to provide essential health care
for people with citizenship problems. The aim of this study was to compare differences in management
of and benefit packages between the PCPS and the UCS in 2020. We applied a descriptive study to review
and analyze related documents as of 1st January 2020. Results indicated that more than 600,000 children
and students of stateless minorities withheld by the cabinet resolution since 2016 were waiting for the
approval of identity to get health benefit. The budget for PCPS did not cover 7 additional items as the
UCS’s budget, including the no-fault compensation to the users and providers of health care. Only three
public hospitals provided health care to the PCPS beneficiaries in Bangkok. In addition, there were 33
different benefits between the PCPS and the UCS. The UCS covered 21 more health interventions and
services than the PCPS. The similar 12 benefit items had different management. Three items in the health
benefit package had different reimbursement rates. The UCS had 9 special management programs more
than the PCPS. Moreover, the PCPS reimbursed 227 items of equipment and prosthesis while the UCS
reimbursed 316. The policy recommendations include increasing the budget for specific service gaps and
items of reimbursable prosthesis and no-fault compensation in health care, increasing provider networks
in Bangkok, and improving management capacity. Further studies on access, efficiency and quality of care
of the PCPS were recommended.
Background: The World Health Organization recommends exclusively breastfeeding (EBF) for the
first 6 months of life. However, infants undergo WHO EBF for 6 months may have an increased risk of
anemia. Evidences regarding anemia associated with EBF are limited in the Northern part of Thailand.
Objective: To investigate the incidence of anemia at 6 months of age among EBF infants and non-EBF
infants, and risk factors of anemia at 6 months of age. Materials and Methods: The retrospective cohort
study was conducted in term-healthy infants at a well-baby clinic, Nakornping Hospital in 2019. Mothers
answered a questionnaire regarding history of breastfeeding. Hematocrit (Hct) level of infants was retrospectively
recorded at birth and 6 months of age. Infants with Hct less than 40% at birth were excluded.
Anemia was defined as Hct less than 33%. Data were analyzed comparing Hct between 2 groups of infants:
the EBF in the first 6 months of age and the non-EBF. Multivariable linear regression and exponential risk
regression were performed to investigate an effect of EBF. Results: Of 259 infants, 137 cases (52.9%) were
male, the overall incidence of anemia was 61 cases (23.6%). Prevalence of 6-month EBF infants was
45.9%. Incidence of anemia in the EBF and non-EBF infants was 24.4 and 22.9%, respectively. When
compared to the non-EBF group, no statistically significant differences were revealed, adjusted RR
0.98(0.61-1.58), p = 0.934. The mean of Hct in EBF and non-EBF infants were 34.18±3.23 and 34.57±3.38,
respectively. There was no statistically significant between mean of Hct of the two groups with adjusted
beta coefficient equals to -0.21(-1.09, 0.66), p = 0.631. Factors predicted anemia in infants at 6 months
of age included maternal age <20 years (adj. OR 3.88, 95%CI 2.68-5.60), >35 years (adj. OR 2.26, 95%CI
1.44-3.53), mothers with HbE positive (adj. OR 3.01, 95%CI 1.62-5.60). Conclusion: Overall incidence of
anemia in infants at 6 months of age was 23.6% classified as a moderate public health problem that
urgent investigation is needed. There was no statistical significance between incidence of anemia in the
EBF and non-EBF infants. EBF for the first 6 months of life does not increase the risk of anemia in healthy
infants compared with non-EBF.
During the COVID-19 pandemic, infants and young children living in poor income families suffered
from food shortage, especially non-breastfed children. The government, civil societies and various organizations
have raised funding and projects calling for the donation of breast-milk substitutes (BMS) in
order to support the affected infants and young children. This article reviewed documents from literature
and news from the Thai media to explore; (1) the situation of infant and young child food shortage in
Thailand, (2) the guidelines on infant and young child feeding during COVID-19 pandemic, focusing on
breastfeeding and formula feeding, (3) the responses from government, and (4) civil society’s contribution
to solve the problem of food shortage. The literature review indicated that breastfeeding was recommended
to all infants and children of COVID-19 positive mothers requiring precautious interventions.
For non-breastfed children from income deficit families, the donation of BMS was urgently needed,
however, the government should plan for long term management on infant and young child feeding
support. This article recommended that relevant stakeholders should closely follow the guidelines for
breastfeeding among COVID-19 positive mothers, draw the lesson learnt from the phenomena of BMS
donation in order to make a better future plan for infant and young child feeding support, and advocate
the promotion, support, and protection of breastfeeding practices in Thailand.
This qualitative study aimed to explore the implementation and key success factors of intermediate
care on patients with stroke, traumatic brain injury, and spinal cord injury according to the Ministry of Public Health’s policy. Seventeen hospitals providing intermediate care to older adults were multi-stage purposively sampled from the MOPH’s provider sampling frame of 897 hospitals covering 4 regions from the north, northeast, central and the south. Key participants comprised 30 executives at the ministry and provinces and 236 intermediate care providers of 17 hospitals. Data were collected by using in-depth interview, group discussion, field study, and were analyzed by content analysis. The findings revealed that: 1. Seventeen hospitals in 8 provinces were categorized based on service activities into 3 groups: 1) the intensive intermediate care provision (6 hospitals), 2) the moderate intermediate care provision (6 hospitals), and 3) the moderate intermediate care with limited evidence on provision (5 hospitals). Constraints were lack of staff’s understanding on policy and practice, specialist staff inadequacy, non-supportive reimbursement system, lack of logistics (budget, space, equipment, medicine and consumable), and inefficient referral and information system, and others. Key success factors of intermediate care were listed: 1) executives with visions, plan, clearly set goal and constant result monitoring, 2) service provider commitment with good teamwork, and 3) service system preparedness, and effective multidisciplinary network. 2. Policy recommendations include clear policy communications cascading with localized flexibility, seamless system integration with adequate health workforce fit with intermediate care demands (which should extend to cover more health problems), high-performance information platform facilitating referral of data among providers and payers, and appropriate and comprehensive payment systems.
Dental caries prevalence was approximately 50% among school-aged children. The permanent
molars had a greater risk of caries than other permanent teeth. The effective measure to prevent caries
on pit and fissure was dental sealant. The objective of this study was to investigate the effectiveness of
three proactive sealant service deliveries implemented in Hat Yai Dental Health Service Network. This
study was a cross-sectional study. The samples consisted of 342 grade 1 students who received the
sealant on 2017 academic year recruited by multistage sampling. The methods were dental examination
for sealant retention and caries on the sealed surfaces and questionnaire survey asking tooth brushing
and eating behaviors. Data were analyzed by using descriptive statistics and logistic regression. The result
showed a 10.1% complete sealant retention rate and a 7.3% caries on seal surfaces after one year. There
was no association between type of service delivery and the sealant retention but the association with
caries on sealed surfaces was found. The probability of getting caries among children who received
dental sealant at sub-district health promoting hospital were 3.7 times (95% CI 1.9-7.3) compared with
hospital clinic and 2.6 times (95% CI 1.4-4.8) compared with mobile dental clinic. Overall, the effectiveness
of the sealant in this study was very low. All three proactive service deliveries had to be improved
to provide the good quality of dental sealant services.
Thailand had implemented the first national steps challenge in 2020 by Ministry of Public Health with the goal to achieve the distance of walking and running at 60 kilometers in 60 days during 1 February to 31 March 2020. The challenge aimed to increase awareness on physical activity at country-wide level. This study aimed to determine the achievement of 60-km goal of Thailand steps challenge season 1. Website-based data of 203,910 records, of participants who sent distance data, was retrieved and analyzed by descriptive parameters and logistic regression. The achievement of accumulative distance of at least 60 km was analyzed by participants’ demographics such as sex, age, body mass index, region, urbanity, and type of participant. The findings revealed that around 46% of participants, who sent distance data, achieved the project goal. Men achieved the goal higher than women. Participants aged 30-59 years, not being obese, living in Bangkok, living in urban areas, and being public health officers, achieved the project goal higher than their counterparts. Being obese, living in rural areas, and being village health volunteers, were less likely to achieve the project goal (adjusted Odds ratio = 0.89, 0.83, 0.43 by multivariate analysis, respectively). The study recommended that the national steps challenge should be continuously implemented by using more strategies to engage participants with different characteristics throughout the project.
The medical marijuana (MMJ) system has been established for the first time in Thai history since February 19, 2019, according to the Narcotic Control Act 2019 (7th edition) . This study aimed to find essential research questions regarding the implementation and impacts of and design the monitoring and evaluation system for the MMJ policy in Thailand. Research methods employed include a literature review, 22 in- depth interviews with key stakeholders, two focus group interviews covering nine service providers and patients, and a participatory observation in the MMJ clinic at the Ministry of Public Health. Our crucial findings cover: (a) the Thai MMJ system is complex, consisting of the sub-systems: modern medicine, Thai traditional medicine, and local community medicine. These three sub- systems are not harmonized. Patients could not access and benefit from the whole system, resulting in many of these patients having to use illegal marijuana products. ( b) MMJ is a new matter in Thailand and could provide both benefits and drawbacks for the Thai society; hence it is essential and urgent for Thailand to have an MMJ related knowledge generation system and an MMJ policy impact monitoring and evaluation system. (c) MMJ movement in Thailand has attributes like “political economy,” which means the MMJ policies may be driven by benefits rather than medical rationale. The proposed policy recommendations include follows. (1) Establish an advisory committee containing various capability dimensions and socially accepted, and have no conflict of interest. (2) Strengthen the MMJ service system in a way incorporating the advantages of all three MMJ sub-systems. (3) Urgently invest in the policy impact monitoring and evaluation system, including evaluating the supply, service utilization, and short-term and long-term consequences. (4) Promote Thai people’s health literacy regarding MMJ is crucial to prevent them from being victims of false information of the illegal MMJ providers. (5) Study the efficacy and the cost-effectiveness of various MMJ products in Thailand using the Thai culture-relevant, modified scientific method. And (6) study future MMJ policies for Thailand to inform policy decision making guided by scientific evidence.
The current situation of the SARS-CoV-2 virus infection causing COVID-19 is more serious. The development of antiretroviral drugs is urgently important. To stop the spread of the virus, the lungs model is critical to develop of antiretroviral drugs. Due to, SARS-CoV-2 relies on the Angiotensin-converting enzyme 2 (ACE2) target receptor protein, which is more common in lung cells, and caused of pneumonia. Thus, the focus of this research is to develop a lung model to study the mechanism of viral infection and develop the treatment of COVID-19, because of it is difficult to study biopsy samples from infected people. The aim of this research project is to simulate lung tissue structures using a technique as the Air-liquid interface to create conditions like the pulmonary scaffolds with ACE2 receptor protein expression. Development of therapeutic and drug testing guidelines for COVID-19. The experimental results in two-dimensional A549 lung cancer cells that were induced inflammation by lipopolysaccharide (LPS) was found the highest protein concentration of 0.2 micrograms per microliter. The nitric oxide measurement was observed in LPS-stimulated samples for 24 hours. Inflammation was observed with low nitric oxide about 2 µM, while the three-dimensional with LPS and hydrogen peroxide (H2O2) stimulation, the nitric oxide was not detected. As for the expression of ACE2 receptor that analyzed by Western blot method, the result can be found at approximately 97 kilodalton (kDa) size of the ACE2 receptor. Consequently, the lungs cancer cell line A549 in three-dimensional Air-Liquid Interface was expression ACE-2 receptor. However, the experiments also need to be repeated in the analysis of ACE2 and AT1R expression and control as beta-actin with western blot, and further at the gene level through qPCR analysis in a two-dimensional versus three-dimensional model. To determine the difference in receptor expression in inflammatory stimulation. The model will further investigation of the substance and the stimulation concentration was selected with spike protein instead for stimulation. The antioxidant was measured, and nitrate content will detect inflammation by LPS and H2O2. The problems that cannot trigger inflammation. So, the experiment still needs quality testing and test the concentration of the substance again.