Purpose: This phenomenological qualitative research investigates Public Health Emergency Management (PHEM) in response to COVID-19, with a specific focus on the case of Thailand’s Health Region 9 (Nakhon Ratchasima) and its program known as COVID-19 Back Home. Method: The study gathers data through in-depth interviews with four groups comprising a total of 112 individuals from three Thai provinces. The collected data is subjected to content analysis, and the findings are analyzed using a framework based on system theory. Results and conclusion: The successful management of subjects returning home is highlighted, resulting in saving numerous patients' lives. The study identifies various suggestions and success factors for each phase of the management process. The research sheds light on PHEM situations in response to COVID-19, specifically examining Health Region 9's COVID-19 Back Home program. Implications of the research: The study provides valuable insights into the inputs, activities, and processes involved in managing such situations, showcasing successful strategies, collaborative efforts, and behavioral changes. Originality/value: The identified suggestions and success factors can inform and improve future management approaches.
A matched case-control study was performed to evaluate the risk factors for and outcomes of healthcare-associated infection due to extended-spectrum beta-lactamase-producing Escherichia coli or extended-spectrum beta-lactamase-producing Klebsiella pneumoniae in Thailand. By multivariable analysis, prior exposure to third-generation cephalosporins and transfer from another hospital were risk factors associated with infection. Receipt of inadequate antimicrobial therapy was a predictor of mortality.
Abstract The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major global concern. Several SARS-CoV-2 gene mutations have been reported. In the current study associations between SARS-CoV-2 gene variation and exposure history during the first wave of the outbreak in Thailand between January and May 2020 were investigated. Forty samples were collected at different time points during the outbreak, and parts of the SARS-CoV-2 genome sequence were used to assess genomic variation patterns. The phylogenetics of the 40 samples were clustered into L, GH, GR, O and T types. T types were predominant in Bangkok during the first local outbreak centered at a boxing stadium and entertainment venues in March 2020. Imported cases were infected with various types, including L, GH, GR and O. In southern Thailand introductions of different genotypes were identified at different times. No clinical parameters were significantly associated with differences in genotype. The results indicated local transmission (type T, Spike protein (A829T)) and imported cases (types L, GH, GR and O) during the first wave in Thailand. Genetic and epidemiological data may contribute to national policy formulation, transmission tracking and the implementation of measures to control viral spread.
Background:The COVID-19 virus has been causing an emerging disease with global outbreaks for over a year.In Thailand, transmission could be controlled by strict measures that could positively and negatively impact physical health and suicidal behavior. Methods:The COVID-19 incidence was retrieved from the Department of Disease Control (DDC).The impact of viral diseases was retrieved from the open-source of the DDC, and King Chulalongkorn Memorial Hospital.The road accidents data were from the Thai Ministry of Transport.The suicidal behavior data were obtained from the Department of Mental Health.We compared data from the year 2019 with the pandemic COVID-19 outbreak period in 2020, before lockdown, during lockdown, easing, and new wave period using unpaired t-test and least-squares linear regression.We compared the impact of the outbreak on various data records in 2020 with corresponding non-outbreak from 2019.Results: There was a significant decline in cases of influenza (p < 0.001) and norovirus (p = 0.01).However, there was no significant difference in RSV cases (p = 0.17).There was a dramatic increase in attempt to suicides and suicides (p < 0.001).There was no impact on roadside accidents and outpatient department visits. Discussion:The extensive intervention measures during lockdown during the first wave positively impacted total cases for each period for acute respiratory and gastrointestinal tract diseases, car accidents, and injuries and negatively impacted indicators of suicidal behavior.The data support government policies that would be effective against the next outbreak by promoting the "new normal" lifestyle.
A matched case-control study was performed to identify predictors of mortality among patients (n = 46) with community-onset infections due to extended-spectrum beta-lactamase-producing Escherichia coli in Thailand. The crude mortality rate was 30%. By multivariable analysis, community-onset bloodstream infection due to extended-spectrum beta-lactamase-producing E. coli was the sole predictor of mortality (adjusted odds ratio, 41.3 [95% confidence interval, 4.3-69.4]; [P= .001).
Abstract The coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a major global concern. Several SARS-CoV-2 gene mutations have been reported. In the current study associations between SARS-CoV-2 gene variation and exposure history during the first wave of the outbreak in Thailand between January and May 2020 were investigated. Forty samples were collected at different timepoints during the outbreak, and parts of the SARS-CoV-2 genome sequence were used to assess genomic variation patterns. The phylogenetics of the 40 samples were clustered into L, G1, G2, O and T types. T types were predominant in Bangkok during the first local outbreak centred at a boxing stadium and entertainment venues in March 2020. Imported cases were infected with various types, including L, G1, G2 and O. In southern Thailand introductions of different genotypes were identified at different times. No clinical parameters were significantly associated with differences in genotype. The results indicated local transmission (type T, Spike protein (A829T)) and imported cases (types L, G1, G2 and O) during the first wave in Thailand. Genetic and epidemiological data may contribute to national policy formulation, transmission tracking and the implementation of measures to control viral spread.
Background: Most ethnic communities in Thailand were settled in remote areas with poor living conditions. Therefore, the “human-centered” concept was adopted to develop community health using the participation process. Objective: This research aimed to develop community health using the participation process at two Pgazkoenyau ethnic (Karen) communities whose environmental contexts were similar, in Tha Song Yang and Mae Ra Mard District, Tak Province. Methods: The multi-stage mixed methods design was applied for data collection. 24 participants were purposely recruited in the qualitative approach due to their responsibility as community health development operators. Qualitative data were collected using semi-structured interviews and analyzed using content analysis. In addition, quantitative data were gained through interview forms and laboratory test reports. Then they were analyzed using descriptive statistics, t-test to compare mean behavioral variables, and z-test to compare the proportion of two communicable diseases and blood chemical residues, with 95% confident interval. Results: The development process consisted of problem finding, data feedback and community stage, capacity building, operation, creative meeting, networking and social capitalizing. They could manage all activities following the community plan: identify helminthiasis and malaria cases, introduce cholinesterase test kits, improve community environmental health, improve healthy behaviors and build capacity for health promotion skills. Evaluated community activities showed increased scores concerning knowledge, attitudes and practices about disease prevention. The prevalence rate of helminths infection decreased significantly. The environmental context was also improved to enable the population’s healthy living conditions. Conclusion: Community development should be based on community resources and all available social and human capital for sustainable development.
It is a quality study using literature review and focus group. This aims to prepare and respond to communicable disease Act B.E. 2558 in Bangkok. There are 3 aspects of problems and recommendations proposed. For the policy aspect, the communicable disease committee should be setting up. At least 2 teams of emergency operation team per one district should be accomplished to cover population. For operation aspect, annual operation plan for disease prevention and control should be prepared. For policy aspect, public and private integration of disease prevention and control is one of the key success factor. The operation center for disease prevention and control should be setting up for monitoring and evaluation. For directing aspect, a technical and advisory committee should be proposed. Three levels of emergency operation team should be accomplished. These are Advance team, Basic team and Community team. For operation aspect, a quarantine center with rapid report and respond for operation plan is one of the most important key success factor. The director of Bangkok district is a key person to represent Bangkok governor for disease control in the district. Many laws and regulation should be approved and enacted as soon as possible. These will lead to better control of communicable disease control according to the law in Bangkok. เปนการจดทำขอเสนอเชงนโยบายการปองกนควบคมโรคตามพระราชบญญตโรคตดตอ พ.ศ. 2558 ในพนท กรงเทพมหานคร เปนการศกษาเชงคณภาพ โดยรวบรวมความรจากเอกสารวชาการและการอภปรายกลม มวตถประสงคเพอจดทำขอเสนอเชงนโยบายการดำเนนงานปองกนควบคมโรคในพนทกรงเทพมหานคร และเพอศกษาการเตรยมความพรอมในการดำเนนงานตามพระราชบญญตโรคตดตอ พ.ศ. 2558 พนทกรงเทพมหานคร ผลการศกษา พบวา ดานนโยบายกรงเทพมหานครควรเรงการจดตงคณะกรรมการโรคตดตอ กรงเทพมหานคร ดานอำวยการ พบวาการจดตงหนวยปฏบตการระดบเขตมความเปนไปไดในการจดตงทมมากทสด โดยควรมหนวยปฏบตการระดบเขต เขตละ 1-2 ทม รวมจำนวน 120 ทม เพอใหครอบคลมในการดแลประชาชน ดานปฏบตการควรจดทำรางแผนปฏบตการเฝาระวง ปองกน และควบคมโรคตดตอหรอโรคระบาดในพนทกรงเทพมหานครทกป ดานการสนบสนนควรอบรมเจาหนาททางการแพทยและสาธารณสข อยางสมำเสมอ ขอเสนอในระดบปฏบตการ ม 4 ดาน คอ ดานนโยบายควรบรณาการการทำงานหนวยงานทเกยวของทงภาครฐและเอกชน จดตงหนวยปฏบตการควบคมโรคตดตอระดบเขตเพอดำเนนการตดตามประเมนผลการดำเนนงาน ดานอำนวยการควรจดตงคณะอนกรรมการดานวชาการโรคตดตอกรงเทพมหานคร ควรจดตงศนยปฏบตการภาวะฉกเฉนทางสาธารณสขกรงเทพมหานคร ควรแตงตงใหมหนวยปฏบตการโรคตดตอใน 3 ระดบ คอ หนวยปฏบตการควบคมโรคตดตอระดบพนท ระดบเขตและระดบสง ดานปฏบตการควรจดหาสถานทรองรบในการแยกกกกนโรค (Quarantine Center) หากเกดโรคตดตออนตราย ควรวเคราะหความเสยงของแผนปฏบตการควบคมโรคตดตออนตราย โรคตดตอทตองเฝาระวงหรอโรคระบาดในพนทกรงเทพมหานคร สนบสนน สงเสรม ตดตามผลการปฏบตงานของหนวยงานทเกยวของกบโรคตดตอในกรงเทพมหานครและปรบขนตอนการรบแจงเหตใหมการสงการทรวดเรวขน โดยใหผอำนวยการเขตดำเนนการแทนผวาราชการ กรงเทพมหานครได ดานการสนบสนน ควรจดหางบประมาณในดานตางๆ ใหเพยงพอ ดำเนนการจดตงคณะกรรมการเพอออกกฎ ระเบยบ ขอบญญตตางๆ ใหเปนไปตามพระราชบญญต อบรมพฒนาศกยภาพบคลากรในระดบตางๆ เตรยมการประชาสมพนธขนตอนและวธการปฏบตตามพระราชบญญตโรคตดตอ พ.ศ. 2558 ใหเขาถง เขาใจและปฏบตไดงาย การดำเนนงานดานควบคมโรคตดตอในเขตเมองมหานคร เชน กรงเทพมหานคร มความยงยากลำบากเปนอยางมาก จงควรทจะชวยกนดำเนนการอยางเอาจรงเอาจง จงจะสามารถควบคมโรคไดสำเรจ
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