Epidemiology of prediabetes mellitus among hill tribe adults in Thailand

Background Prediabetes is a major silent health problem that leads to the development of diabetes within a few years, particularly among those who have a low socioeconomic status. Hill tribe people are vulnerable to prediabetes due to their unique cultural cooking methods and their hard work on farms, as well as their low economic status and educational levels. This study aimed to estimate the prevalence of prediabetes among hill tribe people in Thailand and identify the related factors. Methods This cross-sectional study included participants who belong to one of the six main hill tribes: Akah, Lahu, Hmong, Yao, Karen, and Lisu. The study was conducted in 30 hill tribe villages in Chiang Rai Province, Thailand. A validated questionnaire was administered, and 5-mL blood specimens were collected. Data were collected between November 2019 and March 2020. Logistic regression was used to determine the associations between independent variables and prediabetes. Results A total of 1,406 participants were recruited for the study; 67.8% were women, 77.2% were between 40 and 59 years old, and 82.9% were married. The majority worked in the agricultural sector (57.2%), had an annual income ≤ 50,000 baht (67.5%), and had never attended school (69.3%). The prevalence of prediabetes was 11.2%. After controlling for age and sex, five factors were found to be associated with prediabetes. Members of the Akha and Lisu tribes had 2.03 (95% CI = 1.03–3.99) and 2.20 (95% CI = 1.10–4.42) times higher odds of having prediabetes than Karen tribe members, respectively. Those with hypertension (HT) had 1.47 (95% CI = 1.03–2.08) times higher odds of having prediabetes than those with normal blood pressure. Those with a normal total cholesterol level had 2.43 (95% CI = 1.65–3.58) times higher odds of having prediabetes than those with a high total cholesterol level. Those with a high triglyceride level had 1.64 (95% CI = 1.16–2.32) times higher odds of having prediabetes than those with a normal triglyceride level. Those with a high low-density lipoprotein cholesterol (LDL-C) level had 1.96 (95% CI = 1.30–2.96) times higher odds of having prediabetes than those with a normal LDL-C level. Conclusion Appropriate dietary guidelines and exercise should be promoted among hill tribe people between 30 and 59 years old to reduce the probability of developing prediabetes

Epidemiology of thalassemia among the hill tribe population in Thailand.

BackgroundThalassemia is a severe disease that occurs due to abnormalities in hemoglobin genes. Various genetic factors in different populations lead to different clinical manifestations of thalassemia disease, particularly among people who have a long history of migration and who have married among tribes, such as the hill tribe people in Thailand. This genetic epidemiological study aimed to estimate the prevalence of various forms of thalassemia among the six main hill tribe populations in Thailand.MethodsA cross-sectional study was conducted to obtain information and blood specimens from school children belonging to one of the six main hill tribes in Thailand: Akha, Lau, Hmong, Yao, Karen, and Lisu. Hill tribe children who were attending grades 4-6 in 13 selected schools in Chiang Rai Province, Thailand, were invited to participate in the study. A validated questionnaire and 3 mL blood specimens were collected after obtaining information consent forms from both the children and their parents on a voluntary basis. A complete blood count (CBC) was performed, followed by osmotic fragility (OF) and dichlorophenol indophenol precipitation (DCIP) tests to screen for thalassemia. High-performance liquid chromatography (HPLC) and real-time quantitative polymerase chain reaction (qPCR) were used to identify hemoglobin type and α-thalassemia, respectively. A t-test, chi-square and logistic regression were used to detect the associations between variables at the significance level of α = 0.05.ResultsA total of 1,200 participants from 6 different tribes were recruited for the study; 50.0% were males, and 67.3% were aged 11-12 years. The overall prevalence of thalassemia carriers according to the screening tests was 9.8% (117 of 1,200). Among the cases, 83 were A2A (59 cases were α-thalassemia 1 carrier or α-thalassemia 2 carrier or homozygous α-thalassemia 2, and 24 cases were β-thalassemia trait with or without α-thalassemia); 1 case was EE (homozygous Hb E with or without α-thalassemia); 31 cases were EA (30 cases were the Hb E trait, and 1 case was Hb E trait with or without α-thalassemia); 1 case was A2A Bart's H (Hb H disease α-thalassemia 1/α-thalassemia 2); and 1 case was A2A with abnormal Hb. The prevalence of the α-thalassemia 1 trait among the hill tribe population was 2.5%. The greatest prevalence of the α-thalassemia 1 trait was found in the Karen (3.0%) and Hmong (3.0%) tribes.ConclusionsThe prevalence of some forms of thalassemia in the hill tribe population is higher than that in the Thai and other populations. Effective and available thalassemia screening tests, including essential information to protect the next generation through the specific counseling clinic, are crucial, particularly due to increasing marriages within these populations

Molecular epidemiology and clinical features of hand, foot and mouth disease in northern Thailand in 2016: a prospective cohort study

Abstract Background Hand, foot and mouth disease (HFMD) is a major communicable disease in children ≤6 years old, particularly in several countries in the Asia-Pacific Region, including Thailand. HFMD impacts public health and the economy, especially in northern Thailand. Methods A prospective cohort study was conducted to estimate the incidence rate and to identify the serotype and clinical features of HFMD among children in northern Thailand. A validated questionnaire and throat swab were used for data collection. Polymerase chain reaction (PCR) was used to detect human enterovirus and identify its serotypes. Participants were recruited from 14 hospitals in two provinces in northern Thailand, specifically, Chiang Rai and Pha Yao Province, between January 1, 2016, and December 31, 2016. Chi-square or Fisher’s exact test was used to detect the associations of signs and symptoms with HFMD serotype. Logistic regression was used to detect the associations of variables with a positive enterovirus at alpha = 0.05. Result In total, 612 children aged ≤6 years from Chiang Rai and Pha Yao Province who were diagnosed with HFMD by a throat swab were recruited for the analysis. Approximately half of the cohort was male (57.2%), 57.5% was aged  6 months, and children who had mother who worked as farmers, daily wage employees, and unprofessional skilled jobs had a greater chance of enterovirus infection than those who had unemployed mothers. Coxsackievirus-infected children had a higher rate of rashes on the buttocks, knee, and elbow and fever but a lower rate of lethargy and malaise than EV-A71-infected children. Conclusions EV-A71 is a major cause of HFMD in children < 6 years old in northern Thailand, but rash, fever, and mouth ulcers are mostly found in participants with coxsackievirus infection. Breastfeeding should be promoted during early childhood for at least 6 months to prevent HFMD particularly those mother who are working in unprofessional skill jobs

Factor associated with alcohol use among Lahu and Akha hill tribe youths, northern Thailand

Abstract Background Alcohol use impacts several dimensions, including physical health, mental health, families, and social interactions. This study aimed to estimate the prevalence and to determine the factors associated with alcohol use among Akha and Lahu hill tribe youths in Chiang Rai, Thailand. Methods An analytic cross-sectional design was applied to obtain key data on these associations. The study sample was Akha and Lahu hill tribe youths aged 15-24 years who lived in 30 selected hill tribe villages. A questionnaire was developed from an in-depth interview and group discussion and tested for validation and reliability before use. Descriptive statistics were used to demonstrate the general characteristics, and Chi-square test and logistic regression were used to detect associations between variables at α=0.05. Results A total of 737 subjects were recruited into the study, of whom 50.0% were Lahu. The average age was 17.9 years, 80.7% were single, 71.1% were Christian, 65.9% graduated secondary school, and 65.7% had their major source of income from their parents. Overall, 17.3% smoked and 45.0% drank alcohol. Among the drinkers, 79.8% drank beer, 61.5% started drinking at an age of 15-19 years, 86.8% had drank for < 5 years, 42.5% were persuaded to drink by their peers, 20.2% suffered an accident after alcohol use, and 17.2% had experienced unsafe sex after drinking alcohol. In the multiple logistic regression, six variables were associated with alcohol use among the Akha and Lahu youths. Males had greater odds of alcohol use than females (ORadj = 3.50, 95% CI = 2.24-5.47). Buddhists had greater odds of alcohol use than Christians (ORadj = 1.88, 95% CI = 1.17-3.04). Participants who were unemployed, employed, and in other categories of occupation had greater odds of alcohol use than those who were students (ORadj = 2.20, 95% CI = 1.23-3.92; ORadj = 6.89, 95% CI = 3.38-13.89; and ORadj = 2.96, 95% CI = 1.01-8.59, respectively). Participants whose fathers were daily wage workers had greater odds of alcohol use (ORadj = 2.89; 95% CI = 1.23-6.79) than those whose parents worked in agriculture, and those whose fathers used alcohol had greater odds of alcohol use than those whose fathers did not use alcohol (ORadj = 2.17, 95% CI = 1.40-3.35). Finally, those who had 6-10 and ≥ 11 close friends living in the same village who used alcohol had greater odds of alcohol use (ORadj = 8.51, 95% CI = 3.10-23.3; and ORadj = 3.84, 95% CI = 1.15-12.77, respectively). Conclusion To reduce the initiation of alcohol use among Akha and Lahu youths, public health intervention programs should focus on males who are not attending school and should be implemented for both their family members and peers

Factors associated with domestic violence in the Lahu hill tribe of northern Thailand: A cross-sectional study.

BackgroundDomestic violence significantly affects physical and mental health, particularly among children, women, and the elderly. Living in certain family environments could lead to victimization by domestic violence, especially among families with a poor socioeconomic status, such as the Lahu hill tribe people in Thailand. This study aimed to estimate the prevalence of and determine the factors associated with domestic violence among Lahu children, women, and the elderly.MethodsA cross-sectional study was conducted of participants who belonged to the Lahu hill tribe and lived in 20 selected villages in Chiang Rai Province, Thailand. A validated questionnaire was used to collect personal information and information regarding experiences related to domestic violence in the past year from children (aged 5-15 years), women (aged 16-59 years), and the elderly (aged 60 years and over). A binary logistic regression was used to detect associations between the variables.ResultsA total of 646 participants were recruited into the study, specifically, 98 children aged 5-15 years, 430 women aged 16-59 years, and 118 elderly people. Children who smoked (AOR = 8.70; 95%CI = 1.27-59.45) had greater odds of experiencing domestic violence than children who did not smoke. Women who had a role as a family member (AOR = 1.59; 95%CI = 1.02-2.50), used alcohol (AOR = 3.36; 95%CI = 2.27-4.99), lived in a family with financial problems (AOR = 4.01; 95%CI = 2.52-7.66), and lived with a family member who uses alcohol (AOR = 2.87; 95%CI = 2.20-5.63) had greater odds of suffering domestic violence than women who did not share these characteristics. The elderly who used alcohol (AOR = 3.25, 95%CI = 1.08-9.81), lived with a family member who uses alcohol (AOR = 3.31; 95%CI = 1.26-7.34), or lived in a family with financial problems in the past year (AOR = 2.16; 95%CI = 1.16-8.77) had greater odds of facing domestic violence than the elderly who did not have these characteristics.ConclusionFamily financial problems and substance use are associated with domestic violence in Lahu families in Thailand. Health interventions to reduce the use of substances, including training programs to respond to domestic violence, should be promoted for Lahu children, women, and the elderly