Urbanization and non-communicable disease mortality in Thailand: an ecological correlation study.

This study provides strong evidence from an LMIC that urbanization is associated with mortality from three lifestyle-associated diseases at an ecological level. Furthermore, our data suggest that both average household income and number of doctors per population are important factors to consider in ecological analyses of mortality

Molecular inference of sources and spreading patterns of Plasmodium falciparum malaria parasites in internally displaced persons settlements in Myanmar–China border area

In Myanmar, civil unrest and establishment of internally displaced persons (IDP) settlement along the Myanmar-China border have impacted malaria transmission. The growing IDP populations raise deep concerns about health impact on local communities. Microsatellite markers were used to examine the source and spreading patterns of Plasmodium falciparum between IDP settlement and surrounding villages in Myanmar along the China border. Genotypic structure of P. falciparum was compared over the past three years from the same area and the demographic history was inferred to determine the source of recent infections. In addition, we examined if border migration is a factor of P. falciparum infections in China by determining gene flow patterns across borders. Compared to local community, the IDP samples showed a reduced and consistently lower genetic diversity over the past three years. A strong signature of genetic bottleneck was detected in the IDP samples. P. falciparum infections from the border regions in China were genetically similar to Myanmar and parasite gene flow was not constrained by geographical distance. Reduced genetic diversity of P. falciparum suggested intense malaria control within the IDP settlement. Human movement was a key factor to the spread of malaria both locally in Myanmar and across the international border

Frequent Spread of Plasmodium vivax Malaria Maintains High Genetic Diversity at the Myanmar-China Border, Without Distance and Landscape Barriers

BackgroundIn Myanmar, civil unrest and the establishment of internally displaced person (IDP) settlements along the Myanmar-China border have impacted malaria transmission.MethodsMicrosatellite markers were used to examine source-sink dynamics for Plasmodium vivax between IDP settlements and surrounding villages in the border region. Genotypic structure and diversity were compared across the 3 years following the establishment of IDP settlements, to infer demographic history. We investigated whether human migration and landscape heterogeneity contributed to P. vivax transmission.ResultsP. vivax from IDP settlements and local communities consistently exhibited high genetic diversity within populations but low polyclonality within individuals. No apparent genetic structure was observed among populations and years. P. vivax genotypes in China were similar to those in Myanmar, and parasite introduction was unidirectional. Landscape factors, including distance, elevation, and land cover, do not appear to impede parasite gene flow.ConclusionsThe admixture of P. vivax genotypes suggested that parasite gene flow via human movement contributes to the spread of malaria both locally in Myanmar and across the international border. Our genetic findings highlight the presence of large P. vivax gene reservoirs that can sustain transmission. Thus, it is important to reinforce and improve existing control efforts along border areas

Migration to small rural towns in Thailand

This.work is an analysis of migration to and from small rural towns in Thailand using three sources of data: the 1980 Census of Thailand, a survey of 15 small rural towns and the community-level data. The small rural towns are defined as rural sanitary districts with a population between 1,500 and 5,000. The objectives of the study are mainly concerned with the patterns, the determinants and the consequences of migration to and from the towns. Special attention is also directed to examining the relationship of the patterns of migration with the development level of the towns or their characteristics. Migration to rural towns tends to be from rural areas, a short-distance movement, family migration, and maledominated. The most distinctive pattern is that the towns are more likely to draw their administrative elites and professionals from other towns or cities compared with other categories of residence in the Thai urban hierarchy. This may affect the development process in the towns since the elites tend to be concerned only with their routine work and serve the needs of the central ministries not the needs of local people. The main reason for migration to rural towns was commonly a family-related reason for first-time migrants, long-term migrants and female migrants. Work-related reasons appeared to be the outstanding reasons for male repeat migrants and most male migrants moving from urban areas. However, the majority of migrants said that the presence of kin or friends in the towns was an important factor influencing their migration decision when they were asked about their secondary reasons for migration. Also, a higher level of development in the towns than in the countryside had a significant impact on the migration decision making of many migrants moving from villages. The two most common reasons for out-migration from rural towns were work-related reasons and education. The propensity to migrate out of the towns either permanently or temporarily was obvious among those who were students at,the time of the interview. This is mainly because secondary education is generally the highest level of education provided in the rural towns. Migration from rural towns whether it was a short-term move or long-term move tends to be towards larger towns, namely municipal areas or the capital city. The changes in socio-economic characteristics and improvement in living conditions after migration to rural towns indicate that on average, both return and in-migrants benefited from the changes and experienced considerable improvement. Migrants to rural towns experienced an increase in the positive changes with increasing duration of residence. Non-migrants are used as a reference group to assess migrant adjustment. Living situations in relation to home ownership, housing quality and consumer durables of the household tend to be better for non-migrants and return migrants than for recent and long-term migrants. But occupational prestige of migrants and non-migrants does not differ significantly after controlling for socio-economic characteristics. The majority of migrants felt no difficulties in adapting to life in rural towns because most migrants came from a similar cultural background as they tended to move from the areas near the towns. The development level of the towns shows a positive relationship to the level of in-migration but not the level of out-migration. The sex ratio of migrants to the more developed towns favours females. However, the effect of structure or characteristics of the towns on retaining people in the towns is not very pronounced. The outstanding factor found to have a high and positive relationship to people’s intention to remain in the towns is 'satisfaction with life'. Attempts to increase the level of community satisfaction is thus highly recommended for policies concerned encouraging people to remain in their hometowns or villages. To decentralise power to local people is seen as a way to achieve this goal and to support the ideology of development from below

Integrative analysis of city systems: Bangkok 'man and the biosphere' programme study

This paper argues that integrative analysis of city systems helps us to see beyond their current environmental and social problems to underlying causes, and it suggests different opportunities for possible interventions. Focusing on a single aspect of a city or its people without understanding its context risks interventions which treat symptoms rather than causes and whose short-term 'solution' often means that the problem returns in the same or perhaps a different form. Our integrative analysis of Bangkok suggests that the root of its environmental (and some social) problems lie in decision-making structures and a political culture which has historically fostered self interested decisions by stakeholders rather than the public interest. This has produced a land use and built environment configuration that largely ignores the functioning of the natural flood plain ecosystem and the well-being of residents. People adapt their behaviour to their environment but often in ways that have serious cumulative impacts on the city. This analysis suggests that problems need to be addressed at their source: the nature of decision-making by stakeholders, at every level. This requires the engagement of all parties inside and outside government, the elite and otherwise. To the extent that planning has a viable role, the focus needs to be on the source of the impacts, such as national development planning, rather than in sectors such as transport, where the problems are evident