Journal of disease and health hazard Eastern Region Thailand (JDH)

Factors Associated with drug-resistant tuberculosis (DR-TB) in Health Region 6

Assima Madosod, Natthapon Laochan — Thu, 30 Apr 2026 00:00:00 +0700

The World Health Organization estimates that Thailand has an incidence of multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) of approximately 4 cases per 100,000 population per year. Health Region 6 has reported an increasing number of drug-resistant tuberculosis cases. This study was a case-control study using secondary data from tuberculosis patients registered for treatment in the National Tuberculosis Information Program (NTIP) in Health Region 6 between October 1, 2021 and September 30, 2024. A total of 1,131 patients were included, with a 1:2 ratio between drug-resistant and drug-susceptible tuberculosis patients, selected using systematic random sampling. The data consisted of three domains: personal factors, health-related factors, and tuberculosis treatment–related factors. Data were analyzed using descriptive statistics and multiple logistic regression. The results showed that most tuberculosis patients were male (68.2%), with the highest proportion observed among individuals aged 35–44 years (21.0%), of Thai nationality (94.0%), and unemployed (50.4%). Factors significantly associated with drug-resistant tuberculosis (p-value < 0.05) included pulmonary tuberculosis (aOR = 12.23; 95% CI = 1.97-22.50), relapse tuberculosis (aOR = 8.31; 95% CI = 3.37-20.52), positive AFB smear at diagnosis (aOR = 2.89; 95% CI = 1.83-4.60), HIV infection (aOR = 2.45; 95% CI = 1.22-4.92), diabetes mellitus (aOR = 1.30; 95% CI = 1.12-4.71), and duration of tuberculosis treatment (< 6 months: aOR = 2.07; 95% CI = 1.96-4.46; > 9 months: aOR = 1.11; 95% CI = 1.05-1.21). It is recommended to promote the development of a “One Stop TB Risk Management” policy covering patients with HIV, diabetes mellitus, recurrent tuberculosis, and smear-positive pulmonary tuberculosis. This approach should emphasize intensive screening of high-risk groups, establish drug susceptibility testing as a standing order for all tuberculosis patients, and develop a surveillance system for risk factors.

A comparative study of the results of NCD Clinic service indicators in hospitals under the Office of the Permanent Secretary, of Chachoengsao Province, fiscal year 2024

Unchalee Sungcharoen — Thu, 30 Apr 2026 00:00:00 +0700

This mixed-methods study employed a convergent parallel design to (1) compare service outcome indicators related to glycated hemoglobin (HbA1c) control among diabetic patients aged below 60 years and those aged 60 years and above across hospitals in Chachoengsao Province; (2) examine the operational model of NCD Clinic Plus in terms of service systems and personnel; and (3) analyze the relationship between HbA1c control outcomes and service system and policy-related factors. The quantitative component was a total population study of 43,873 patients, without sampling. Data were obtained from the Data Exchange system within the Health Data Center between October 2023 and March 2024. Descriptive statistics and the Kruskal–Wallis test were applied, with effect size (η²) reported. The qualitative component involved in depth interviews with one clinic nurse from each of 11 hospitals. The interview guide demonstrated perfect content validity (IOC = 1.00), and data were analyzed using content analysis before being integrated with quantitative findings. The results revealed statistically significant differences in HbA1c control across hospitals. Qualitative findings indicated that multidisciplinary service models, the application of DM Remission approaches, and supportive policies were associated with better outcomes. Enhancements in information systems, adoption of digital technologies, and community engagement were also identified as key strategies for strengthening and sustaining high quality NCD care.

Effects of Using the Blood Culture Clinical Practice Guideline among Personnel at Chulabhorn Hospital, Nakhon Si Thammarat Province

Jariya Niyomros — Thu, 30 Apr 2026 00:00:00 +0700

This one-group pretest–posttest experimental study aimed to evaluate the effects of implementing a blood culture collection practice guideline at Chulabhorn Hospital, Nakhon Si Thammarat Province, Thailand. The study compared personnel knowledge, blood culture contamination rates, and satisfaction with the guideline. All 26 registered nurses in the nursing department were included in the study was conducted from November 2023 to January 2024. Data collection instruments included a demographic form, a knowledge assessment on blood culture collection, a satisfaction questionnaire, and laboratory-reported blood culture results. Content validity was confirmed by three experts, and the reliability of the knowledge and satisfaction instruments demonstrated Cronbach’s alpha coefficients of 0.90. Data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics, including paired t-test and Fisher’s exact test. Statistical significance was set at p-value < 0.05. The results showed that the mean knowledge score after implementation was significantly higher than before implementation (= 12.1 ± 1.7 vs. = 14.7 ± 0.7; t = −7.5, p-value < 0.001). The blood culture contamination rate decreased from 5.7% (5/87 samples) to 0% (0/78 samples), with a statistically significant difference (p = 0.039). Overall satisfaction with the guideline was high ( = 4.8 ± 0.3). The findings indicate that implementing the guideline, together with training and supervision, effectively improved personnel knowledge, reduced contamination rates, and enhanced patient safety. The guideline should be integrated into routine practice and developed into a continuous quality monitoring system within healthcare settings.

Policy Evaluation of the “Thais Free from Non-Communicable Diseases(NCDs)” Initiative : A Case Study in Chonburi Province, 2025

Somjai Wiriyapongrat — Thu, 30 Apr 2026 00:00:00 +0700

Non-communicable diseases (NCDs) remain a major public health challenge, particularly in the Eastern Economic Corridor (EEC) of Thailand, where rapid industrialization, high labor mobility, and lifestyle constraints limit effective health management. Despite the continuous implementation of the “Thais Free from NCDs” policy, there remains a lack of empirical evidence at the local level regarding the gap between service coverage and health outcomes. This study aimed to evaluate the implementation of this policy in Chonburi Province. A Mixed-Research method was employed under a health policy evaluation framework, integrating formative and summative evaluations to examine both implementation processes and outcomes. The study covered 33 subdistricts across 11 districts. Participants included 44 stakeholders and 148 patients. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed through thematic analysis. The findings revealed that the policy was effectively implemented at the local level, with a shift from hierarchical governance to network-based collaboration, where social capital played a key role in facilitating coordination. However, a critical systemic paradox was identified: despite achieving high service coverage and meeting key performance indicators (100%), population health outcomes did not significantly improve. This reflects a gap between knowledge, attitudes, and health behaviors, alongside limitations in fragmented data systems and service models that do not align with the working lifestyles in industrial areas. These findings suggest that policy success cannot rely solely on increasing service coverage but depends on the system’s capacity to integrate service delivery, population behavior, and health information into meaningful health outcomes. Therefore, proactive and flexible service models-such as after-hours services, workplace-based interventions, and digital health monitoring-should be developed, alongside integrated data systems, to enhance policy effectiveness in the EEC context.

An Influenza A (H1N1) Outbreak Investigation in a Prison, Samut Prakan Province, May 2025

Khrongkwan Phudeebut, Suppasit Srisaeng, Noppharat Nonglak — Thu, 30 Apr 2026 00:00:00 +0700

On 6 May 2025, the Office of Disease Prevention and Control Region 6, Chonburi Province, received a report of an influenza A outbreak in a prison in Samut Prakan Province, with 71 cases testing positive by rapid influenza diagnostic tests. On 7 May 2025, a joint outbreak investigation team conducted a field investigation to confirm the diagnosis and outbreak, describe epidemiological characteristics, identify risk factors, and implement control measures. The investigation included a descriptive epidemiological study, active case finding, laboratory testing, and an environmental assessment, as well as an analytical study using a case–control design. Univariate analysis was performed using the Chi-square test, and variables with p-value < 0.05 were included in multivariable analysis using multiple logistic regression. A total of 92 cases met the case definition (attack rate: 4.7%), with one death reported (case fatality rate: 1.1%). The cases were classified as 11 suspected, 71 probable, and 10 confirmed cases. All cases were male inmates in Zone 7, aged 18-77 years (median age: 37 years). The most common symptoms were fever (100%), cough (67.4%), myalgia (55.4%), and rhinorrhea (54.4%). Significant risk factors associated with illness included not receiving influenza vaccination (adjusted odds ratio [aOR] = 2.17, 95% CI: 1.18–3.98), sharing meals with infected individuals (aOR = 3.20, 95% CI: 1.21–8.48), and inconsistent use of face masks (aOR = 9.31, 95% CI: 2.63–32.89). Contributing factors to the outbreak included the introduction of infection from outside the prison and close-contact group activities. Therefore, appropriate quarantine measures should be implemented for inmates who need to leave the prison, along with strict monitoring of face mask use, physical distancing during group activities, and personal hygiene practices to prevent future outbreaks.