Thailand's health screening policy and practices: The case of Burmese migrants with tuberculosis

Burmese migrant workers who work legally in Thailand have to follow a migrant registration system, which includes a health screening procedure. This paper investigates the health screening procedure of Burmese migrants in Thailand. Since ethnography is very useful for social research, the investigator of this study employed an ethnographic perceptive, in which the dual roles of the ethnographer are used to develop an understanding of what it is like to live in a particular setting: the investigator must both become a part of the lives of the participants of the study while also maintaining the role of an observer. The information in this study was also derived from in-depth interviews, field notes, and formal and informal interviews with 13 migrant workers with tuberculosis (TB), 4 members of a TB self-help group, 4 migrant health volunteers, 17 family members of TB patients, and 5 hospital staff. The results of the study showed that the screening of the health of Burmese migrant workers was associated with discrimination, fear that the migrants might spread TB, and the government's concern about the treatment cost. The screening for the health of migrants is especially presented as a health policy to monitor health issues and to prevent the spread of infectious disease to the Thai people

Prognostic Factors for Leptospirosis Infection Severity

Background: Leptospirosis is an important health problem in Thailand. People infected with leptospirosis may not have any mild symptoms, whereas some people have acute and severe illnesses. It is crucial to strengthen critical patients’ diagnosis and treatment to prevent severe complications and reduce mortality. This study was performed to explore a set of parameters for the prediction of severe leptospirosis illness under routine clinical practice. Methods: A case-control study was conducted in eight general hospitals in Thailand. Retrospective collection data were used, and key information was retrieved from inpatient medical files. Patients were grouped into two severity categories, severe and non-severe infection. Backward elimination was used to reach the final multivariate model. Results: The six significant predictors identified in the study were hemoptysis (OR = 25.80, 95% CI 5.69, 116.92), hypotension (blood pressure 14,000/µL (OR = 5.12, 95% CI 2.75, 9.51), hematocrit ≤ 30% (OR = 3.49, 95% CI 1.61, 7.57), and jaundice (OR = 3.11, 95% CI 1.71, 5.65). These predictors could correctly predict the severity of leptospirosis infection in 91.31% of the area under the receiver operation curve (AuROC). Conclusions: The results of this study showed that severe leptospirosis infections have identifiable predictors. The predictors may be used to develop a scoring system for predicting the level of severity