Health-Related Quality of Life as Measured by EQ-5D and TFLIC-2 in Liver Cancer Patients

Objective: To assess the relation and estimation function between utility weight (UW) from EQ-5D and T-FLIC 2 score (TFS). To compare quality of life (QOL) between global burden of disease (GBD) and TNM staging. Methods: All liver cancer patients which presented in selected hospitals in 2009, were asked their QOL by EQ-5D and T-FLIC 2 questionnaires. The relation between UW and TFS was analyzed by using Pearson’s correlation and the linear regression. The means of UW and TFS in specific conditions were compared with independent t-test and ANOVA. Results: There were 53 cases. The majority (73.6 %) were men, mean age was 57.2 years, lived in suburban area (67.9%), worked in agriculture (47.2%) and graduated secondary level or lower (83.0%). These 73.6% of all samples had household monthly income not greater than 5,000 THB and used universal coverage scheme (64.2%). Seventeen cases had not been identified TNM staging because of the condition of patients. However, those cases fulfilled to be diagnosed terminal stage. The multiple comparisons between means of UW and TFS showed no statistical significance e.g. pre-terminal and terminal (0.5 vs. 0.4, p=0.3 and 38.8 vs. 34.0, p=0.2 respectively), TNM-stage 4 vs. TNM-stage 1-3 (0.3 vs 0.5, p=0.3 and 38.9, 30.5, p=0.1), and supportive only vs. other treatment (0.5 vs 0.5, p=0.9, and 32.8 vs 36.2, p=0.5). The correlation between UW and TFS was significantly related (p<0.001) with linear pattern (p<0.001). The equation for estimating UW from TFS and specific Q1-Q22 questions was formulated. Conclusion: This study revealed the significant correlation between UW and TFS with linear pattern. A major advantage of using regression analysis was predicting UW from TFS for economic evaluation in Thai liver cancer patients. The treatment might not alter QOL significantly. Given cancer stage and treatment choice and their QOL in this study, our findings should not be over-interpreted

Prediction of HIV mortality in Thailand using three data sets from the national AIDS program database

HIV continues to hinder the growth and development of a country and identifying the mortality rate will help to address this problem. Therefore, we sought to examine HIV mortality in Thailand in the years 2014 and 2015. A retrospective study was conducted to investigate HIV mortality in all regions of Thailand. For the reliability of this study, the data were drawn from two main sources, Bureau of Registration and Administration (BORA) and the National Health Security Office (NHSO) of Thailand. A total of 23,243 deaths were recorded in years 2014 and 2015. Negative binomial regression was used to predict and compare HIV mortality rates by year, age group and gender. The overall HIV mortality accounted for 2.6% of all reported deaths, representing 18.3 deaths per 100,000 populations. Among HIV deaths, 91% of them participated in the National AIDS Program (NAP) and 56% of them received Antiretroviral Therapy (ART). There was statistically significant effect, with males having a higher death rates than females. Despite the relevance of reduction of HIV mortality in Thailand, our study clearly shows that HIV mortality in Thailand is much dependent on age and gender. Thus, we suggest continued effort is needed to address gender and age difference

Post universal health coverage trend and geographical inequalities of mortality in Thailand

BACKGROUND: Thailand has achieved remarkable improvement in health status since the achievement of universal health coverage in 2002. Health equity has improved significantly. However, challenges on health inequity still remain.This study aimed to determine the trends of geographical inequalities in disease specific mortality in Thailand after the country achieved universal health coverage. METHODS: National vital registration data from 2001 to 2014 were used to calculate age-adjusted mortality rate and standardized mortality ratio (SMR). To minimize large variations in mortality across administrative districts, the adjacent districts were systematically grouped into “super-districts” by taking into account the population size and proximity. Geographical mortality inequality among super-districts was measured by the coefficient of variation. Mixed effects modeling was used to test the difference in trends between super-districts. RESULTS: The overall SMR steadily declined from 1.2 in 2001 to 0.9 in 2014. The upper north and upper northeast regions had higher SMR whereas Greater Bangkok achieved the lowest SMR. Decreases in SMR were mostly seen in Greater Bangkok and the upper northern region. Coefficient of variation of SMR rapidly decreased from 20.0 in 2001 to 12.5 in 2007 and remained close to this value until 2014. The mixed effects modelling revealed significant differences in trends of SMR across super-districts. Inequality in mortality declined among adults (≥15 years old) but increased in children (0–14 years old). A declining trend in inequality of mortality was seen in almost all regions except Greater Bangkok where the inequality in SMR remained high throughout the study period. CONCLUSIONS: A decline in the adult mortality inequality across almost all regions of Thailand followed universal health coverage. Inequalities in child mortality rates and among residents of Greater Bangkok need further exploration

Revising the WHO verbal autopsy instrument to facilitate routine cause-of-death monitoring.

OBJECTIVE: Verbal autopsy (VA) is a systematic approach for determining causes of death (CoD) in populations without routine medical certification. It has mainly been used in research contexts and involved relatively lengthy interviews. Our objective here is to describe the process used to shorten, simplify, and standardise the VA process to make it feasible for application on a larger scale such as in routine civil registration and vital statistics (CRVS) systems. METHODS: A literature review of existing VA instruments was undertaken. The World Health Organization (WHO) then facilitated an international consultation process to review experiences with existing VA instruments, including those from WHO, the Demographic Evaluation of Populations and their Health in Developing Countries (INDEPTH) Network, InterVA, and the Population Health Metrics Research Consortium (PHMRC). In an expert meeting, consideration was given to formulating a workable VA CoD list [with mapping to the International Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) CoD] and to the viability and utility of existing VA interview questions, with a view to undertaking systematic simplification. FINDINGS: A revised VA CoD list was compiled enabling mapping of all ICD-10 CoD onto 62 VA cause categories, chosen on the grounds of public health significance as well as potential for ascertainment from VA. A set of 221 indicators for inclusion in the revised VA instrument was developed on the basis of accumulated experience, with appropriate skip patterns for various population sub-groups. The duration of a VA interview was reduced by about 40% with this new approach. CONCLUSIONS: The revised VA instrument resulting from this consultation process is presented here as a means of making it available for widespread use and evaluation. It is envisaged that this will be used in conjunction with automated models for assigning CoD from VA data, rather than involving physicians

Burden of disease in Thailand: changes in health gap between 1999 and 2004

<p>Abstract</p> <p>Background</p> <p>Continuing comprehensive assessment of population health gap is essential for effective health planning. This paper assessed changes in the magnitude and pattern of disease burden in Thailand between 1999 and 2004. It further drew lessons learned from applying the global burden of disease (GBD) methods to the Thai context for other developing country settings.</p> <p>Methods</p> <p>Multiple sources of mortality and morbidity data for both years were assessed and used to estimate Disability-Adjusted Life Years (DALYs) loss for 110 specific diseases and conditions relevant to the country's health problems. Causes of death from national vital registration were adjusted for misclassification from a verbal autopsy study.</p> <p>Results</p> <p>Between 1999 and 2004, DALYs loss per 1,000 population in 2004 slightly decreased in men but a minor increase in women was observed. HIV/AIDS maintained the highest burden for men in both 1999 and 2004 while in 2004, stroke took over the 1999 first rank of HIV/AIDS in women. Among the top twenty diseases, there was a slight increase of the proportion of non-communicable diseases and two out of three infectious diseases revealed a decrease burden except for lower respiratory tract infections.</p> <p>Conclusion</p> <p>The study highlights unique pattern of disease burden in Thailand whereby epidemiological transition have occurred as non-communicable diseases were on the rise but burden from HIV/AIDS resulting from the epidemic in the 1990s remains high and injuries show negligent change. Lessons point that assessing DALY over time critically requires continuing improvement in data sources particularly on cause of death statistics, institutional capacity and long term commitments.</p

Children’s and adolescents’ rising animal-source food intakes in 1990–2018 were impacted by age, region, parental education and urbanicity

Animal-source foods (ASF) provide nutrition for children and adolescents’ physical and cognitive development. Here, we use data from the Global Dietary Database and Bayesian hierarchical models to quantify global, regional and national ASF intakes between 1990 and 2018 by age group across 185 countries, representing 93% of the world’s child population. Mean ASF intake was 1.9 servings per day, representing 16% of children consuming at least three daily servings. Intake was similar between boys and girls, but higher among urban children with educated parents. Consumption varied by age from 0.6 at <1 year to 2.5 servings per day at 15–19 years. Between 1990 and 2018, mean ASF intake increased by 0.5 servings per week, with increases in all regions except sub-Saharan Africa. In 2018, total ASF consumption was highest in Russia, Brazil, Mexico and Turkey, and lowest in Uganda, India, Kenya and Bangladesh. These findings can inform policy to address malnutrition through targeted ASF consumption programmes.publishedVersio

Incident type 2 diabetes attributable to suboptimal diet in 184 countries

The global burden of diet-attributable type 2 diabetes (T2D) is not well established. This risk assessment model estimated T2D incidence among adults attributable to direct and body weight-mediated effects of 11 dietary factors in 184 countries in 1990 and 2018. In 2018, suboptimal intake of these dietary factors was estimated to be attributable to 14.1 million (95% uncertainty interval (UI), 13.8–14.4 million) incident T2D cases, representing 70.3% (68.8–71.8%) of new cases globally. Largest T2D burdens were attributable to insufficient whole-grain intake (26.1% (25.0–27.1%)), excess refined rice and wheat intake (24.6% (22.3–27.2%)) and excess processed meat intake (20.3% (18.3–23.5%)). Across regions, highest proportional burdens were in central and eastern Europe and central Asia (85.6% (83.4–87.7%)) and Latin America and the Caribbean (81.8% (80.1–83.4%)); and lowest proportional burdens were in South Asia (55.4% (52.1–60.7%)). Proportions of diet-attributable T2D were generally larger in men than in women and were inversely correlated with age. Diet-attributable T2D was generally larger among urban versus rural residents and higher versus lower educated individuals, except in high-income countries, central and eastern Europe and central Asia, where burdens were larger in rural residents and in lower educated individuals. Compared with 1990, global diet-attributable T2D increased by 2.6 absolute percentage points (8.6 million more cases) in 2018, with variation in these trends by world region and dietary factor. These findings inform nutritional priorities and clinical and public health planning to improve dietary quality and reduce T2D globally.publishedVersio

Malaria epideMics under cliMate change scenarios in thailand โรคระบาดของมาลาเรี ยภายใต้ สภาวะภู มิ อากาศเปลี ่ ยนแปลงในประเทศไทย chayut pinichka ชยุ ตม์ พิ นิ จค้ า 1* กั มปนาท ภั กดี กุ ล 1 ศรั ณยา สุ จริ ตกุ ล 1 และ กนิ ษฐา บุ ญธรรมเจริ ญ 2 1 คณะสิ ่ งแ

Abstract the objective of this study was to estimate avoidable burden on disease of malaria in thailand under climate conditions in the future. the study was based on climate projection under 2 different situations which included the regionally economic development (a2) and the local environmental sustainability (B2). 1991-2011 climate data collection was used to create nonlinear mixed regression model. the variables in monthly time step, which included maximum temperature, minimum temperature, precipitation, humidity, average wind speed. The results were found the best fitting model, model 2, which adjusted r-square = 0.818 and rMse = 763.27. the average disease incidence in the year of 2003-2011 on B2 = 26,869 persons/yr, baseline = 28,521 persons/yr, and a2 = 30,734 persons/yr. these burdens converted to dalYs for international comparison which were, baseline = 1,391 dalYs/yr, a2 = 1,500 dalYs/yr, and B2 = 1,301 dalYs/yr. the compared model with actual climate data to predict the incidence of malaria in 2012-2020 found malaria incidence ha

Diseases Burden of Chronic Obstructive Pulmonary Disease (COPD) Attributable to Ground-Level Ozone in Thailand:Estimates Based on Surface Monitoring Measurements Data

BACKGROUND: Ambient ozone (O(3)) pollution has increased globally since preindustrial times. At present, O(3) is one of the major air pollution concerns in Thailand, and is associated with health impacts such as chronic obstructive pulmonary disease (COPD). The objective of our study is to estimate the burden of disease attributed to O(3) in 2009 in Thailand based on empirical evidence. METHODS: We estimated disability-adjusted life years (DALYs) attributable to O(3) using the comparative risk assessment framework in the Global Burden of Diseases (GBD) study. We quantified the population attributable fraction (PAF), integrated from Geographic Information Systems (GIS)-based spatial interpolation, the population distribution of exposure, and the exposure-response coefficient to spatially characterize exposure to ambient O(3) pollution on a national scale. Exposure distribution was derived from GIS-based spatial interpolation O(3) exposure model using Pollution Control Department Thailand (PCD) surface air pollution monitor network sources. Relative risk (RR) and population attributable fraction (PAF) were determined using health impact function estimates for O(3). RESULT: PAF (%) of COPD attributable to O(3) were determined by region: at approximately, Northern = 2.1, Northeastern = 7.1, Central = 9.6, Eastern = 1.75, Western = 1.47 and Southern = 1.74. The total COPD burden attributable to O(3) for Thailand in 2009 was 61,577 DALYs. Approximately 0.6% of the total DALYs in Thailand is male: 48,480 DALYs; and female: 13,097 DALYs. CONCLUSION: This study provides the first empirical evidence on the health burden (DALYs) attributable to O(3) pollution in Thailand. Varying across regions, the disease burden attributable to O(3) was 0.6% of the total national burden in 2009. Better empirical data on local specific sites, e.g. urban and rural areas, alternative exposure assessment, e.g. land use regression (LUR), and a local concentration-response coefficient are required for future studies in Thailand

Health Burden of Extreme Weather in Thailand

This study assessed and evaluated the variation of the health burden in response to extreme weather events that occurred in Thailand from 2006 to 2010. The health burden was assessed using disability-adjusted life years (DALYs) lost and deaths from injuries as its indicators. Thailand has a DALYs lost of over 16,274 from extreme weather events. Extreme weather events include floods, flash floods, and severe storms, and most of the DALYs in Thailand were lost from floods (approximately 12,872 DALYs). The second most impactful weather event was severe storms, with losses of approximately 2,019 DALYs, followed by flash floods, which caused losses of about 1,383 DALYs. Climate change is a cause of extreme weather events, and a relationship betweenclimate and health has been found worldwide. Improved long-term, high-quality data sets are needed to better analyze and improve accuracy of the health burden