History Of Criminal Offense And Adverse Childhood Experiences With Relapse Among Adolescent Substance Abusers In Treatment Centers Of The Department Of Medical Services, Ministry Of Public Health, Thailand

Relapse is a common feature of drug addiction, and chronic drug use and relapse creates elevated risk for serious illness. This research had the objective to study the characteristics of relapse among adolescent substance abusers and examine the association between history of criminal offense and adverse childhood experience with relapse. This study used data from a cross-sectional survey of 373 persons age 18-24 years with a history of use of an addictive drug (including alcoholic beverage and cigarettes). The sample was drawn from the population admitted for drug treatment at rehabilitation centers under the Department of Medical Services, Ministry of Public Health of Thailand, during May to August, 2018. The research protocol and data collection instruments were approved by the Ethical Review Committee of Mahidol University and the MOPH. The sample in this study was predominately male (75.9%), age under 20 years (31.4%), single (64.1%), Buddhist (91.2%), gainfully employed (53.9%), with high school or higher education (70.5%), working in wage labor (49.8%), and had been in drug treatment more than once (38.9%). The youngest age at first drug use in this sample was 10 years. Three-fourths (72.4%) had history of trouble with the police before, 31.9% had been arrested for a drug offense, and 7.5% had been arrested for other charges. Fully 82.6% reported having at least one adverse childhood experience (ACE); nearly half (45.0%) reported that someone in the household was addicted to alcohol or other addictive substance. Other types of family dysfunction include divorced/separated parents (43.2%), and history of emotional abuse (42.6%). Having had one or more ACE, female, and had ever had poly-drug use were significantly associated with relapse among adolescent substance abusers in the drug treatment programs. The study highlights the importance of tailoring treatment to address risk factors for relapse

Gender difference in betel quid consumption levels and tobacco use among adults in Myanmar

Several small scaled studies in Myanmar investigated determinants of betel quid chewing status but to better understand more complete profiles of betel quid chewing habits, this study investigated the associations of betel quid consumption levels with tobacco and sociodemographic factors using a nationally representative sample in Myanmar. A cross-sectional, secondary data analysis was conducted by using Myanmar demographic and health survey (MDHS) (2015-2016). Chi-square tests and multinomial logistic regression were performed with p-value<0.05 as significance. Men averagely chewed 5.59 (SD=8.229) pieces per day while women chewed 1.25 (SD=3.584) pieces. The prevalence of chewing daily pieces 1-2, 3-5 and 6+ were 7.9%, 17.1% and 34.2% for men and 6.1%, 8% and 7.1 %, respectively, for women. In multivariate analysis, low education, low family wealth, married, and urban were more likely to chew 6+ pieces per day relevant to no consumption in both genders, while a positive association with age was observed only in women. Tobacco use was associated with low consumption level (1-2 pieces), relative to no consumption in both genders. Therefore, this study underlined the need to improve knowledge on the dangers associated with betel quid chewing and tobacco use among socially disadvantaged populations and urban residents

Prevalence And Patterns Of Polysubstance Use Among Adolescents In Bangkok, Thailand

Many unhealthy behaviors often begin during adolescence, and substance use is one of the most problematic issues for this age group. Substance use has a major impact on individuals, families, and communities, as its effects are cumulative, contributing to costly social, physical, financial and health problems, including mental health problems. Prior research shows that use of polysubstance is associated with even higher risks and worse consequences than single substance use, but little is known about the demographic factors associated with polysubstance use. The current study examines the prevalence and correlates of self-reported substance and polysubstance use among a cohort of Bangkok 11th grade students. Using data from the Bangkok Behavior Surveillance Survey (n=1,755), researcher estimated the prevalence of various patterns of adolescent use of alcohol, cigarette and marijuana in the past 12 months, individually and in combination. While 72.0% of individuals reported no substance use prior to age 16, the most common substance used in past 12 months was alcohol (26.2%), followed by cigarette (14.4%), and marijuana (5.9%). Nearly one in seven (14.1%) reported that either early use of both alcohol and marijuana or alcohol, marijuana and cigarettes, indicating the relatively high prevalence of this type of polysubstance use behavior among adolescents. Other findings indicate that substance use varied somewhat by demographic characteristics. Polysubstance use was more prevalent among males than females. The prevalence of marijuana use, cigarette smoking and binge drinking was higher among adolescents whose socio economic status were low compared to those with moderate or high socio economic status. This study confirms the elevated prevalence and importance of polysubstance use behavior among adolescents prior to age 16, and puts early onset of alcohol, marijuana and cigarette use into the context of use patterns rather than single drug exposures. Study limitations include the somewhat attenuated response rate, limited sample size relative to other national epidemiological studies, and the cross-sectional design

Factors Influencing Contraceptive Use Among Myanmar Migrant Women In Bangkok, Thailand: A Community-based Survey

Objectives: Nowadays, more people are moving residence permanently or temporarily, and international migration is one of the dominant issues globally. During migration, the individuals may experience poverty and unavailability of health care services -- especially for women – and that leads to unmet need for reproductive health and inadequate access to contraception which increases risk of unplanned pregnancy and unsafe abortion. This study explored the level of contraceptive use and associated factors among Myanmar migrant women in Bangkok.Method: A cross-sectional study was conducted during March to April, 2018, 314 women were selected by snowball sampling and interviewed using a structured questionnaire. Descriptive statistics and logistic regression were used for data analysis.Results: The prevalence of contraceptive use among women who were living with their husband/partner was 77.1%; oral pills and injection were the most common methods. The sample’s median age was 30 years (QD = 4.5 years), half of the respondents were ethnic Burmese (51.9%), and were covered by health insurance (47.5%). Only one-fourth of the women (25.5%) could communicate well in Thai. Predictors of contraceptive use include being younger than 25 years (AOR=9.6; 95% CI=3.07–31.59), having more than one child (AOR=8.5; 95% CI=2.72-26.37), having a supportive husband and friends, neighbors (AOR=4.9; 95% CI=2.43-10.26, AOR=4.2; 95% CI=1.96-8.89) having easy access to contraception (AOR=3.2; 95% CI=1.50–6.780) and being able to access contraception at local health outlets (AOR=12.9; 95% CI=4.01-41.93).Conclusion: The study suggests that provision of community and workplace education, health care services and initiation of help-lines in the Burmese language may increase visibility of reproductive health services and bridge the gap between the foreign migrants and the Thai public health system. Active male involvement in their partner’s reproductive health is an important source of support

Factors contributing to the voluntary counseling and HIV testing for persons at risk of HIV infection in Thailand

Thailand has a policy to support access to voluntary HIV counseling and testing (VCT) for all its citizens.  Thais are eligible for two free VCT sessions per year and this has increased clinic uptake, but the total is still well below the target coverage (10% testing for the general population and 90% for the higher-risk populations). The objective of this research was to study the factors which enabled persons at risk of HIV to obtain VCT in Thailand. This research was a cross-sectional study and used questionnaires to ask respondents about risk behavior, self-risk assessment, benefits coverage, measures and service system, attitudes toward VCT, self-stigma, prejudice toward others, and experience of discrimination.  Data were collected during May to July 2013 in eight, purposively-selected provinces which are the part of the focus area for the 2012-16 National AIDS Program Plan (NAP). The method for selecting respondents used time-location quota sampling to achieve a total sample of 751 persons. This study found that proportion who had VCT in the year prior to the survey was 56%.   The significant enabling factors associated with VCT were having someone encourage them to go for testing and receiving information about VCT.  In addition, other significant factors for FSW were self-assessed risk for HIV and having had risk behavior. Other significant factors for MSM were awareness of eligibility for VCT and age 24 years or older. Thus, in order to achieve the VCT target for higher-risk populations by 2016, there should be special mechanisms to inform the different groups about the VCT service and motivation to go for VCT, along with improvements in outreach services to make VCT more convenient for Key affected populations include an annual health check

Clinical audit of adherence to hypertension treatment guideline and control rates in hospitals of different sizes in Thailand

A clinical audit of hospitals in Thailand was conducted to assess compliance with the national hypertension treatment guidelines and determine hypertension control rates across facilities of different sizes. Stratified random sampling was used to select sixteen hospitals of different sizes from four provinces. These included community (120 beds) hospitals. Among new cases, the audit determined whether (i) the recommended baseline laboratory assessment was completed, (ii) the initial choice of medication was appropriate based on the patient's cardiovascular risk, and (iii) patients received medication adjustments when indicated. The hypertension control rates at six months and at the last visit were recorded. Among the 1406 patients, about 75% had their baseline glucose and kidney function assessed. Nearly 30% (n = 425/1406) of patients were indicated for dual therapy but only 43% of them (n = 182/425) received this. During treatment, 28% (198/1406) required adjustments in medication but this was not done. The control of hypertension at six months after treatment initiation was 53% varying between 51% in community and 56% in large hospitals (p p < .01). Failure to adjust medication when required was associated with 30% decrease in the odds of hypertension control (OR 0.69, 95% CI 0. 50 to 0.90). Failure to comply with the treatment guidelines regarding adjustment of medication and lost to follow-up are possible target areas to improve hypertension control in Thailand

Associations between adverse childhood experiences and adverse health outcomes among adolescents in Bangkok, Thailand

The association of adverse childhood experiences (ACEs) on health outcomes has garnered attention as a public health concern. The present study aimed to examine the prevalence and associations between ACEs and adverse health outcomes among adolescents. In 2017, a cross-sectional study was conducted to identify the retrospective prevalence of ACEs and their association with adverse health conditions. A total of 2,058 adolescents completed the on-line questionnaire. Exposures included psychological, physical, and sexual forms of abuse, neglect and violence as well as household dysfunction. Main outcome measures included sexual behavior, drinking, illegal drug use, smoking, depression, and anxiety. Multiple logistic regression assessed the independent relationship between individual ACEs, ACE score categories, and adverse health conditions in adolescents, while controlling for covariates. A total of 51.4 % of respondents reported at least one ACE and 12.2% reported three or more ACEs. A score of >3 ACEs was associated with increased odds of experiencing high anxiety (AOR = 3.91, 95%CI = 2.92,5.25), high depression (AOR = 4.02, 95%CI = 3.00,5.38), sexual experience (AOR = 3.12, 95%CI = 2.23,4.37), binge drinking (AOR = 3.32, 95%CI = 1.74,3.08), smoking (AOR = 3.14, 95%CI = 2.31,4.28), and illegal drug use (AOR = 2.59, 95%CI = 1.80,3.67). The study found a link between exposure to multiple ACEs and anxiety, depression, alcohol use, tobacco use, and illicit drug use. In addition, the individual ACEs had different effects on adverse health conditions. Finally, the individual ACEs had different effects on adverse health outcome. In addition to having a cumulative effect, individual ACE components have differential effects on adverse health outcome, after controlling for important confounders

HIV risk-related sexual behavior by cohabiting partner status among factory workers: Results from the 2015 Bangkok behavioral surveillance survey (BSS)

This study aimed to determine the prevalence of HIV risk-related sexual behaviors in the past 12 months and their related factors by cohabiting partner status among factory workers in Bangkok, one of the higher AIDS disease-burden provinces. The study found that one in five factory workers engaged in at least one of three HIV risk-related sexual behaviors, including ever-sex and unprotected-sex with a non-regular partner and multiple sexual partners. Those without a cohabiting partner (52%) were 4-fold greater than those with a cohabiting partner (13%). Factors associated with sexual risk behavior include being male, being younger, and having had HIV risk-related sexual behavior at first sex, regardless of cohabiting partner status (despite positive association with frequent alcohol consumption for those without a cohabiting partner). These findings imply the need for promotion of condom use in all episodes of sex with a potentially risk partner, reduction of non-regular partner sex and provision of education for safe sex for Bangkok factory workers

Factors Related to Regular Use of ANC Services among Mothers of Children under One Year of Age in Rural Communities of Banke District, Nepal

Introduction: The aim of this study was to identify the prevalence and factors associated with regular use of ANC services among mothers of children under one year of age in rural communities in Nepal. WHO has estimated that developing-region maternal mortality still remains as the leading cause of death among reproductive-age women, accounting for approximately 99% of global maternal deaths in 2015. Method: A community-based crosssectional study was conducted in Banke District, Nepal among a sample of 364 pregnant women who delivered within last 12 months using face-to-face interviews with a semi-structured questionnaire. Results: Nearly 56% of women used standard ANC services in the last pregnancy (i.e., four or more check-ups). Around 30% of mothers had at least one complication during the pregnancy. ANC visits increase with decreased distance from a health center (AOR=2.197, 95% CI=1.165-4.144), decreased travelling cost (AOR=2.573, 95% CI=1.062 –4.484), decreased waiting time for service (AOR=2.940, 95% CI =1.445-5.981), increased quality of ANC services (AOR =2.099, 95% CI=1.247-3.536) and increased satisfaction of service (AOR =1.942 , 95% CI =1.212-3.110). Increased positive perception about ANC also increased the number of ANC visits. Further information from TV programs also helped to increase ANC visitation. Conclusion: Factors affecting regular utilization of ANC services were affordability and accessibility, such as distance to the health center, travel cost, waiting time, quality of ANC services and service satisfaction among lower-income, rural Nepalese women