ABSTRACT Anti-H5N1 antibody was determined by microneutralization, hemagglutination inhibition, and Western blotting assays in serial blood samples collected from eight Thai patients, including four fatal cases and four survivors. The antibody was detected as early as 5 days and, typically, with an increase in titer in paired blood at about 15 days after disease onset. The anti-H5 antibody response was long-lasting, for almost 5 years in cases which can be followed that far. In addition, cross-neutralizing activity to related clade 1 viruses was observed.
.02 H5N1 infection confirmed by RT-PCR, real-time RT-PCR, and/or viral culture results. Ten (77%) of these 13 patients had specimens submitted for nasopharyngeal rapid testing, and 3 (30%) of these 10 patients had nasopharyngeal rapid test results positive for H5N1. Of note, 1 patient with H5N1 infection received neuraminidase inhibitor 148 h before specimen collection and had negative nasopharyngeal rapid test results. Our findings have some important implications. Although physicians tend to submit multiple specimens from each index patient, and although suboptimal specimen collection and processing were identified less commonly after the educational program, we found no difference in the diagnostic yield of the rapid test. With the increase in neuraminidase inhibitor supply in Thailand, physicians tend to prescribe this medication to the index patient long before specimen collection. Because rapid diagnosis for H5N1 infection can be difficult [3], we emphasize the importance of treating physicians obtaining multiple adequate, deep specimens from patients before the administration of antiviral medication to the index patient.
To describe a comprehensive survey of the practice of electroconvulsive therapy (ECT) in Asia.Between 2001 and 2003, a 29-item questionnaire was sent to 977 psychiatric facilities in 45 Asian countries.Completed questionnaires were returned by 334 (34.2%) institutions in 29 (64.4%) countries. Electroconvulsive therapy was available in 257 institutions in 23 countries. During the year before the survey, 39,875 patients (62% men) received a mean of 7.1 ECT treatments. Most patients (73.1%) were 18 to 44 years old; few were younger than 18 years (6.0%) or older than 64 years (4.4%). Indications for ECT were schizophrenia (41.8%), major depression (32.4%), mania (14.0%), catatonia (6.9%), drug abuse (1.8%), dysthymia (1.6%), and others. Brief-pulse ECT devices were used in only 115 (58.4%) of 197 institutions. Routine electroencephalographic monitoring was conducted in only 59 (23.0%) institutions. Bilateral electrode placement was invariable in 202 (78.6%) institutions. Unmodified ECT was administered to 22,194 (55.7%) patients at 141 (54.9%) institutions in 14 countries. Continuation ECT was available in only 115 (44.7%) institutions in 17 countries. No institution had a formal ECT training program.The practice of ECT in Asia may seem suboptimal: schizophrenia, not depression, is the most common indication; most institutions offer sine-wave ECT; unmodified ECT is commonly administered; bilateral electrode placement is invariable in most institutions; electroencephalographic monitoring is uncommon; continuation ECT is infrequent; and no formal training in ECT is available. We speculate that the suboptimal practices reflect felt needs and ground realities in standards of medical care in developing countries rather than a misuse of ECT.
Fish-borne parasitic zoonosis such as Opisthorchiasis caused by Opisthorchis viverrini remains a major public health problem in many parts of Southeast Asia and Me Kong Basin region including Thailand. The focal point of Opisthorchiasis is located in north-eastern part of Thailand, along with high prevalence coincidence of cholangiocarcinoma, a major primary carcinoma of the liver with a very poor prognosis. Opisthorchis viverrini infection caused by developed cholangiocarcinoma (CCA). O. viverrini infection is acquired by eating raw or partially cooked fish. In endemic areas, several food preparations contain uncooked or raw freshwater fish. The most common local freshwater fish used for this recipe are Koi Pla, Pla Som, Lab Pla and Pla Yang or Grill fish. Raw fish dishes are known to be associated with the risk of liver fluke infection due to the consumption of cyprinoid fish that contains metacercaria of O. viverrini. Grill fish and Lab-Pla are among the famous Thai traditional food in the northeastern and northern part of Thailand. The consumption of raw Grill fish can lead to O. viverrini infection because cyprinoid fish is a second intermediate host of O. viverrini. This study investigated the literature of previous working for prevention and control of Opisthorchiasis and confirm worm-free cooking safety of cooking with consideration of time for the preparation of freshwater fish-grill for the prevention and control of Opisthorchiasis and Cholangiocarcinoma infection. The unique experiment experimental designed. The freshwater fishes grill within the group of 0,1,2,3,4 and 5 minutes with 10 fresh water fishes from fisherman in Nakhon Phanom and Sakhon Nakorn provinces which reported high O. viverrini infection among risk people in 2009. The another experiment using frozen freshwater fish at -10 degree for 5 days. The results showed that metacercariae remained active in control and 1-2 minutes experimental groups. The groups 3-5 minutes of grill fish partially cooked showed inactive metacercariae. The excretory bladder spread with unclear form. The conclusion suggested that worm-free cooking under review, and unique experiment of cook safety is a crucial basic knowledge leading to bringing knowledge, practically for the prevention and control Liver fluke infection. Recommendation information also let people better understand the concerns during health literacy program to stop transmission of liver fluke and need to be discussed among head villagers, public health agencies and teachers in the public participation process and school health program.
An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
An abstract is not available for this content so a preview has been provided. As you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Background: Opisthorchiasis is a chronic parasitological disease. It is one of the significant public health problems in Southeast Asia, especially Thailand. This action based research aimed to study an application of community participation for behavior development to prevent Opisthorchiasis among select resident in Kwae Noi Dam, Phitsanulok province. Methods: A total of 70 participants were selected. The process was divided into two phases. The first group was educated about situation analysis in the community, channels for health information, stakeholders, and food training. The second group was trained about prevention planning which composed of demonstration, modeling, group discussion, campaigning for prevention and rewards. In each implementation stage qualitative and quantitative methods were used for data collection. Data collection included information regarding socio-demographics, knowledge, perception of protection motivation, and preventive behavior. For the qualitative data, the content analysis was made according to framework and key themes that reflected the meanings and values of the learning management process. The quantitative data was analyzed by descriptive statistics including percentage, mean, standard deviation, Chi-square, and Fisher’s exact test. Results: More than 70% of participants’ scores had improved significantly with marked increases in knowledge and perception toward preventive behavior for Opisthorchiasis. The learning processes were developed based on the real problems and the direct experience of the samples. Conclusion: Processes and models are important instruments that affect the prevention of Opisthorchiasis among people (by using appropriate strategies and methodologies). The lessons learned will be useful for educational institutions, in addition to which, this innovative model can be applied to anyone. Moreover, this model not only provides a new academic experience but also suggests a new policy for community participant learning .
Abstract Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 emerged in December 2019 and has spread globally. Although Thailand has been effective at controlling the spread of COVID-19, disease surveillance and information on antibody responses in infected cases and close contacts are needed because there is still no specific treatment or vaccine available. We investigated 217 recovered COVID-19 cases to monitor their viral RNA shedding and production of antibodies against SARS-CoV-2. The presence of antibodies in blood samples from 308 close contacts of COVID-19 cases was also determined. Viral RNA was still detectable in 6.6 % of recovered COVID-19 cases. The most prolonged duration of viral RNA shedding detected in this study was 105 days. IgM, IgG, and IgA antibodies against SARS-CoV-2 were detected in 13.82, 88.48, and 83.41 % of the recovered cases 4–12 weeks after disease onset, respectively. Although the patients had recovered from their illness, the levels of antibodies detected showed association with their symptoms during their stay in hospital. Fifteen of the 308 contacts (4.87 %) of COVID-19 cases tested positive for IgG antibodies. The presence of antibodies against SARS-CoV-2 suggested that there was viral exposure among close contacts. Viral clearance and the pattern of antibody responses in infected individuals are both crucial for effectively combatting SARS-CoV-2. Our study provides additional information on the natural history of this newly emerging disease related to both natural host defenses and a strategy for vaccine development.
Background Melioidosis is a serious infectious disease caused by the Category B select agent and environmental saprophyte, Burkholderia pseudomallei. Most cases of naturally acquired infection are assumed to result from skin inoculation after exposure to soil or water. The aim of this study was to provide evidence for inoculation, inhalation and ingestion as routes of infection, and develop preventive guidelines based on this evidence. Methods/Principal Findings A prospective hospital-based 1∶2 matched case-control study was conducted in Northeast Thailand. Cases were patients with culture-confirmed melioidosis, and controls were patients admitted with non-infectious conditions during the same period, matched for gender, age, and diabetes mellitus. Activities of daily living were recorded for the 30-day period before onset of symptoms, and home visits were performed to obtain drinking water and culture this for B. pseudomallei. Multivariable conditional logistic regression analysis based on 286 cases and 512 controls showed that activities associated with a risk of melioidosis included working in a rice field (conditional odds ratio [cOR] = 2.1; 95% confidence interval [CI] 1.4–3.3), other activities associated with exposure to soil or water (cOR = 1.4; 95%CI 0.8–2.6), an open wound (cOR = 2.0; 95%CI 1.2–3.3), eating food contaminated with soil or dust (cOR = 1.5; 95%CI 1.0–2.2), drinking untreated water (cOR = 1.7; 95%CI 1.1–2.6), outdoor exposure to rain (cOR = 2.1; 95%CI 1.4–3.2), water inhalation (cOR = 2.4; 95%CI 1.5–3.9), current smoking (cOR = 1.5; 95%CI 1.0–2.3) and steroid intake (cOR = 3.1; 95%CI 1.4–6.9). B. pseudomallei was detected in water source(s) consumed by 7% of cases and 3% of controls (cOR = 2.2; 95%CI 0.8–5.8). Conclusions/Significance We used these findings to develop the first evidence-based guidelines for the prevention of melioidosis. These are suitable for people in melioidosis-endemic areas, travelers and military personnel. Public health campaigns based on our recommendations are under development in Thailand.
'%3e%3ccircle r='20' fill='%23008'/%3e%3ccircle r='17.5' fill='%23fff'/%3e%3ccircle r='3.5' fill='%23008'/%3e%3cg id='d'%3e%3cg id='c'%3e%3cg id='b'%3e%3cg id='a' fill='%23008'%3e%3ccircle r='.875' transform='rotate(7.5 -8.75 133.5)'/%3e%3cpath d='M0 17.5.6 7 0 2l-.6 5L0 17.5z'/%3e%3c/g%3e%3cuse xlink:href='%23a' transform='rotate(15)'/%3e%3c/g%3e%3cuse xlink:href='%23b' transform='rotate(30)'/%3e%3c/g%3e%3cuse xlink:href='%23c' transform='rotate(60)'/%3e%3c/g%3e%3cuse xlink:href='%23d' transform='rotate(120)'/%3e%3cuse xlink:href='%23d' transform='rotate(-120)'/%3e%3c/g%3e%3c/svg%3e)