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

Years of healthy life lost due to adverse pregnancy and childbirth outcomes among adolescent mothers in Thailand

Background: Preventing adolescent pregnancy and childbirth is one of the targets of Sustainable Development Goals. Measuring the burden pregnancy and childbirth places on adolescents is required to convince society and decision makers that this is an important goal. Objective: This study aimed to estimate (1) the years of healthy life lost due to adolescent pregnancy and childbirth in terms of disability adjusted life years (DALYs), (2) the contribution of adolescent pregnancy and childbirth to the total DALYs lost from all reproductive ages, and (3) the magnitude of the burden due to five main direct obstetric causes and sequelae in adolescent mothers in Thailand in 2014. Methods: Data were retrieved from a national in-patient registered database and a vital registration database. Health consequences of five main direct obstetric causes were extracted from the Global Burden of Diseases (GBD) 2000 study. The DALYs were calculated by the combination of Years of Life Lost (YLL) due to premature death and Years Lived with Disability (YLD) due to adverse pregnancy and childbirth in adolescent mothers. Results: There were a total of 2599 years of DALYs lost from the consequences of adolescent pregnancy and childbirth, and unsafe abortion resulted in the highest burden. Mortality was the primary driver for the total DALYs lost with 1704 years, and maternal hemorrhage dominated in the total YLL. Unsafe abortion contributed the highest burden to nonfatal morbidity. Obstructed labor commonly occurred in adolescent pregnancies. Conclusion: Among the DALYs lost due to pregnancy and childbirth for all reproductive aged women, 15.4% were attributed to adolescents. The five main obstetric causes of mortality and morbidity are all preventable conditions. Increased efforts from all stakeholders are essential to implement appropriate interventions to minimize adverse health outcomes in adolescent mothers

Burden of disease attributed to ambient air pollution in Thailand: A GIS-based approach.

Growing urbanisation and population requiring enhanced electricity generation as well as the increasing numbers of fossil fuel in Thailand pose important challenges to air quality management which impacts on the health of the population. Mortality attributed to ambient air pollution is one of the sustainable development goals (SDGs). We estimated the spatial pattern of mortality burden attributable to selected ambient air pollution in 2009 based on the empirical evidence in Thailand.We estimated the burden of disease attributable to ambient air pollution based on the comparative risk assessment (CRA) framework developed by the World Health Organization (WHO) and the Global Burden of Disease study (GBD). We integrated geographical information systems (GIS)-based exposure assessments into spatial interpolation models to estimate ambient air pollutant concentrations, the population distribution of exposure and the concentration-response (CR) relationship to quantify ambient air pollution exposure and associated mortality. We obtained air quality data from the Pollution Control Department (PCD) of Thailand surface air pollution monitoring network sources and estimated the CR relationship between relative risk (RR) and concentration of air pollutants from the epidemiological literature.We estimated 650-38,410 ambient air pollution-related fatalities and 160-5,982 fatalities that could have been avoided with a 20 reduction in ambient air pollutant concentrations. The summation of population-attributable fraction (PAF) of the disease burden for all-causes mortality in adults due to NO2 and PM2.5 were the highest among all air pollutants at 10% and 7.5%, respectively. The PAF summation of PM2.5 for lung cancer and cardiovascular disease were 16.8% and 14.6% respectively and the PAF summations of mortality attributable to PM10 was 3.4% for all-causes mortality, 1.7% for respiratory and 3.8% for cardiovascular mortality, while the PAF summation of mortality attributable to NO2 was 7.8% for respiratory mortality in Thailand.Mortality due to ambient air pollution in Thailand varies across the country. Geographical distribution estimates can identify high exposure areas for planners and policy-makers. Our results suggest that the benefits of a 20% reduction in ambient air pollution concentration could prevent up to 25% of avoidable fatalities each year in all-causes, respiratory and cardiovascular categories. Furthermore, our findings can provide guidelines for future epidemiological investigations and policy decisions to achieve the SDGs

Spatial interpolation of change in concentrations (ΔX) of Thailand 2009.

<p>(a) PM10 (μgm^-3), (b) NO2 (ppb) and (c) PM2.5 (μgm^-3).</p

Avoidable mortality and the percentage of deaths estimated to be caused by level of air pollutant in Thailand (2009).

<p>Avoidable mortality and the percentage of deaths estimated to be caused by level of air pollutant in Thailand (2009).</p

Relative risk and population-attributable fractions (PAFs) based on level of ambient air pollutants in Thailand, 2009.

<p>Relative risk and population-attributable fractions (PAFs) based on level of ambient air pollutants in Thailand, 2009.</p

Annual average and predicted concentrations (1997–2009) by monitoring stations.

<p>(a) PM₁₀ and (b) NO₂.</p

Summary of statistical significance of the air quality data and spatial interpolation models.

<p>Summary of statistical significance of the air quality data and spatial interpolation models.</p