Prevalence and Factors Associated with Abnormal Cervical Cell among the Hmong and Mien Hill Tribe Women in Pha Yao Province, Thailand

Objective: To estimate the prevalence and to determine factor associated with abnormal cervical cell among the Hmong and Mien hill tribe women. Methods: A cross-sectional study aimed to estimate the prevalence and to determine the factors associated with abnormal cervical cell among the Hmong and Mien hill tribe women living in Pha Yao province, Thailand was conducted. The data from validated questionnaires and Papanicolaou (Pap) smear test results were collected. Logistic regression was used to detect the associations between variables and abnormal cervical cell at the significant level of alpha = 0.05. Results: Totally, 450 Hmong and Mien women were recruited into the analysis. The overall prevalence of abnormal cervical cell was 2.2%; 1.2% were atypical squamous cells of undetermined significance (ASC-US), 0.4% were atypical squamous cells-cannot exclude HSIL (ASC-H), 0.4% were cervical intraepithelium neoplasia-I (CIN-I) and 0.2% were cervical intraepithelium neoplasia-II (CIN-II). Two variables, the number of their sexual partners and the number of husbands’ sexual partners, were significantly associated with abnormal cervical cell. The women who had ≥ 4 sexual partners had a 7.09 times (95%CI=1.85-27.17) more likely to have abnormal cervical cell than those who had < 4 sexual partners. The women whose husbands had ≥ 4 partners had a 5.63 times (95%CI=1.51-20.90) more likely to have abnormal cervical cell than those whose husbands had < 4 sexual partners. Conclusion: The number of sexual partners is significantly associated with abnormal cervical cell among the Hmong and Mien hill tribe women. Health interventions regarding safe sex should be promoted in the hill tribe people

Prevalence and Factors Associated with Abnormal Cervical Cell among the Hmong and Mien Hill Tribe Women in Pha Yao Province, Thailand

Objective: To estimate the prevalence and to determine factor associated with abnormal cervical cell among the Hmong and Mien hill tribe women. Methods: A cross-sectional study aimed to estimate the prevalence and to determine the factors associated with abnormal cervical cell among the Hmong and Mien hill tribe women living in Pha Yao province, Thailand was conducted. The data from validated questionnaires and Papanicolaou (Pap) smear test results were collected. Logistic regression was used to detect the associations between variables and abnormal cervical cell at the significant level of alpha = 0.05. Results: Totally, 450 Hmong and Mien women were recruited into the analysis. The overall prevalence of abnormal cervical cell was 2.2%; 1.2% were atypical squamous cells of undetermined significance (ASC-US), 0.4% were atypical squamous cells-cannot exclude HSIL (ASC-H), 0.4% were cervical intraepithelium neoplasia-I (CIN-I) and 0.2% were cervical intraepithelium neoplasia-II (CIN-II). Two variables, the number of their sexual partners and the number of husbands’ sexual partners, were significantly associated with abnormal cervical cell. The women who had ≥ 4 sexual partners had a 7.09 times (95%CI=1.85-27.17) more likely to have abnormal cervical cell than those who had < 4 sexual partners. The women whose husbands had ≥ 4 partners had a 5.63 times (95%CI=1.51-20.90) more likely to have abnormal cervical cell than those whose husbands had < 4 sexual partners. Conclusion: The number of sexual partners is significantly associated with abnormal cervical cell among the Hmong and Mien hill tribe women. Health interventions regarding safe sex should be promoted in the hill tribe people

Childhood TB epidemiology and treatment outcomes in Thailand: a TB active surveillance network, 2004 to 2006

<p>Abstract</p> <p>Background</p> <p>Of the 9.2 million new TB cases occurring each year, about 10% are in children. Because childhood TB is usually non-infectious and non-fatal, national programs do not prioritize childhood TB diagnosis and treatment. We reviewed data from a demonstration project to learn more about the epidemiology of childhood TB in Thailand.</p> <p>Methods</p> <p>In four Thai provinces and one national hospital, we contacted healthcare facilities monthly to record data about persons diagnosed with TB, assist with patient care, provide HIV counseling and testing, and obtain sputum for culture and susceptibility testing. We analyzed clinical and treatment outcome data for patients age < 15 years old registered in 2005 and 2006.</p> <p>Results</p> <p>Only 279 (2%) of 14,487 total cases occurred in children. The median age of children was 8 years (range: 4 months, 14 years). Of 197 children with pulmonary TB, 63 (32%) were bacteriologically-confirmed: 56 (28%) were smear-positive and 7 (4%) were smear-negative, but culture-positive. One was diagnosed with multi-drug resistant TB. HIV infection was documented in 75 (27%). Thirteen (17%) of 75 HIV-infected children died during TB treatment compared with 4 (2%) of 204 not known to be HIV-infected (p < 0.01).</p> <p>Conclusion</p> <p>Childhood TB is infrequently diagnosed in Thailand. Understanding whether this is due to absence of disease or diagnostic effort requires further research. HIV contributes substantially to the childhood TB burden in Thailand and is associated with high mortality.</p

Directly Observed Therapy and Improved Tuberculosis Treatment Outcomes in Thailand

BACKGROUND: The World Health Organization (WHO) recommends that tuberculosis (TB) patients receive directly observed therapy (DOT). Randomized controlled trials have not consistently shown that this practice improves TB treatment success rates. In Thailand, one of 22 WHO-designated high burden TB countries, patients may have TB treatment observed by a health care worker (HCW), family member, or no one. We studied whether DOT improved TB treatment outcomes in a prospective, observational cohort. METHODS AND FINDINGS: We prospectively collected epidemiologic data about TB patients treated at public and private facilities in four provinces in Thailand and the national infectious diseases hospital from 2004-2006. Public health staff recorded the type of observed therapy that patients received during the first two months of TB treatment. We limited our analysis to pulmonary TB patients never previously treated for TB and not known to have multidrug-resistant TB. We analyzed the proportion of patients still on treatment at the end of two months and with treatment success at the end of treatment according to DOT type. We used propensity score analysis to control for factors associated with DOT and treatment outcome. Of 8,031 patients eligible for analysis, 24% received HCW DOT, 59% family DOT, and 18% self-administered therapy (SAT). Smear-positive TB was diagnosed in 63%, and 21% were HIV-infected. Of patients either on treatment or that defaulted at two months, 1601/1636 (98%) patients that received HCW DOT remained on treatment at two months compared with 1096/1268 (86%) patients that received SAT (adjusted OR [aOR] 3.8; 95% confidence interval [CI] 2.4-6.0) and 3782/3987 (95%) patients that received family DOT (aOR 2.1; CI, 1.4-3.1). Of patients that had treatment success or that defaulted at the end of treatment, 1369/1477 (93%) patients that received HCW DOT completed treatment compared with 744/1074 (69%) patients that received SAT (aOR 3.3; CI, 2.4-4.5) and 3130/3529 (89%) patients that received family DOT (aOR 1.5; 1.2-1.9). The benefit of HCW DOT compared with SAT was similar, but smaller, when comparing patients with treatment success to those with death, default, or failure. CONCLUSIONS: In Thailand, two months of DOT was associated with lower odds of default during treatment. The magnitude of benefit was greater for DOT provided by a HCW compared with a family member. Thailand should consider increasing its use of HCW DOT during TB treatment

Knowledge attitude and practice regarding prevention of needle stick injuries among nursing students in Henan province, China

Objective: The purpose of study was to identify the knowledge, attitude and practice of prevention NSIs among nursing students in Henan province, China. Methods: A cross-sectional study of 400 nursing students in 7 nursing education institutes in Henan province during June to July 2019 was performed. Structured questionnaires were used to assess participants' knowledge, attitudes and practices of prevention NSIs. Chi-square tests were used to assess correlations between variables. Multivariate regression analysis was used to test the factors related to prevention NSIs. Results: It has shown that 67% of nursing students suffered at least one NSI during their internship. The most common cause of injury was the injection process, the venous catheter management process, and the disposing all kinds of needle waste process (p<0.05). Female students showed more than three times greater chance of intentionally breaking needle after injection (OR 2.50, 95%CI 1.03-6.08). Capping needles always used by two hand (OR 0.40, 95%CI 0.19-0.85) and separating the needle from the syringe by hand after injection (OR 0.23, 95%CI 0.16-0.57) were negatively related to bachelor students. Conclusion: Nursing students show high prevalence of NSIs and lack of prevention knowledge, attitude, and practice. It’s necessary to develop and increase occupational safety protection courses and establish regulations for the prevention of NSIs. Continuous..

Evaluating the potential impact of the new Global Plan to Stop TB: Thailand, 2004–2005

OBJECTIVE: WHO's new Global Plan to Stop TB 2006-2015 advises countries with a high burden of tuberculosis (TB) to expand case-finding in the private sector as well as services for patients with HIV and multidrug-resistant TB (MDR-TB). The objective of this study was to evaluate these strategies in Thailand using data from the Thailand TB Active Surveillance Network, a demonstration project begun in 2004. METHODS: In October 2004, we began contacting public and private health-care facilities monthly to record data about people diagnosed with TB, assist with patient care, provide HIV counselling and testing, and obtain sputum samples for culture and susceptibility testing. The catchment area included 3.6 million people in four provinces. We compared results from October 2004-September 2005 (referred to as 2005) to baseline data from October 2002-September 2003 (referred to as 2003). FINDINGS: In 2005, we ascertained 5841 TB cases (164/100 000), including 2320 new smear-positive cases (65/100 000). Compared with routine passive surveillance in 2003, active surveillance increased reporting of all TB cases by 19% and of new smear-positive cases by 13%. Private facilities diagnosed 634 (11%) of all TB cases. In 2005, 1392 (24%) cases were known to be HIV positive. The proportion of cases with an unknown HIV status decreased from 66% (3226/4904) in 2003 to 23% (1329/5841) in 2005 (P< 0.01). Of 4656 pulmonary cases, mycobacterial culture was performed in 3024 (65%) and MDR-TB diagnosed in 60 (1%). CONCLUSION: In Thailand, piloting the new WHO strategy increased case-finding and collaboration with the private sector, and improved HIV services for TB patients and the diagnosis of MDR-TB. Further analysis of treatment outcomes and costs is needed to assess this programme's impact and cost effectiveness

Characteristics of eligible TB patients, stratified by inclusion or exclusion from two month and end of treatment analysis.

*<p>Mobile was defined as not living in the same district for at least three of the past six months.</p>#<p>MTB denotes <i>Mycobacterium tuberculosis</i>, and NTM denotes non-tuberculous mycobacteria.</p