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The purpose of this paper is to investigate the prevalence and factors related to cognitive impairment among hill-tribe older people in Chiang Rai province, Thailand.

A cross-sectional study was carried out amongst 459 hill-tribe older people aged 60 years and above. A Mini Mental State Examination (MMSE) Thai 2002 version was used for cognitive screening. A questionnaire and medical records were used for demographic and clinical data collection while descriptive statistics were used to analyze characteristic data. Potential factors related to cognitive impairment were analyzed by using univariate logistic regression analysis.

The prevalence of cognitive impairment amongst the participants was 49.89 percent (95% CI 45.32%, 53.47 percent). Factors related to cognitive decline included no occupation (OR=1.49, 95% CI 1.10–2.03, p<0.04) and a history of amphetamine use (OR=1.57, 95% CI 1.09–2.33, p<0.04).

Cognitive decline should be a cause for concern amongst Thai hill-tribe older people, especially amongst those in the group with a history of amphetamine use. However, Thai health care professionals need to be aware of the potential cultural bias in the MMSE Thai 2002 version as a cognition test targeted at the hill-tribe population as the questionnaire may not provide a true reflection of their cultural experience and background.

The purpose of this paper is to estimate the cost-effectiveness of tuberculosis (TB) treatment and care in two Thai hospitals located on the borders with Myanmar and Laos.

A retrospective data collection was conducted to analyze all costs relevant to TB treatment and care from Mae Sai and Chiang Sean Hospitals. The cost related to TB treatment and care and the number of successful TB treatment from January 1 to December 31, 2017 were used for the calculation. The cost-effectiveness ratio (C/E) and the incremental cost-effectiveness ratio (ICER) were the outcomes.

In 2017, the total cost of the TB treatment and care program at Mae Sai Hospital was 482,728.94 baht for 57 TB patients. The cast per treated case per year was 8,468.93 baht. The C/E was 10,971.11 baht per successful TB treatment (44 successful cases). The total cost of the TB treatment and care program at Chiang Sean Hospital was 330,578.73 baht for 39 TB patients. The cost per treated case per year was 8,476.38 baht. The C/E was 22,038.58 baht per successful TB treatment (15 successful cases). The ICER was 5,246.56 baht. The Mae Sai Hospital model was more cost-effective in terms of the treatment and care provided to Burmese patients with TB than the Chiang Sean Hospital model for Laotian patients with TB.

To improve the cost-effectiveness of TB treatment and care programs for foreign patients in hospitals located on the Thai border, focus should be placed on patient follow-up at the community or village level.

This qualitative approach study aimed to understand the barriers to accessing a tuberculosis (TB) clinic in a Thai hospital as experienced by TB patients from Myanmar living on the Thailand-Myanmar border.

Twenty-two participants were asked to provide information. In-depth interviews were used to gather the information. Each interview lasted 40 min.

TB patients from Myanmar experience several barriers to accessing TB treatment and care at Mae Sai Hospital, such as language and economic problems, although they are very satisfied with the quality of service and positive attitude of the health care providers. A long waiting time and lack of explanation of the pathogenesis of TB were noted as negative aspects by the patients and their relatives. The medical staff at the TB clinic were negatively affected by the excessive workload and unsuitability of some methods or technologies. Using budgetary subsidies from agencies to fund TB care and treatment was not sustainable. Foreign TB patients are not subsidized by the national universal insurance scheme of Thailand, and sending TB patients back to their home country is sometimes unavoidable.

Thailand and Myanmar should strengthen their collaboration and develop a system to improve the quality of TB patient care and management for those who are living in poverty and lack education, by focusing on reducing language and economic barriers to accessing health care services including support for medicines and laboratory materials related to TB case management among these populations.

The purpose of this paper is to determine the factors associated with DF occurrence in recurrence villages in Chiang Rai, Thailand.

A case-control study was conducted between June 2017 and December 2017. A validated questionnaire was used to detect the factors associated with recurrence of DF. χ² and logistic regression were used to detect the associations between variables at α=0.05.

In total, 213 cases and 436 controls were recruited into the analysis. Cases were recruited from 20 DF recurring villages, while controls were recruited from 20 non-DF recurring villages in Chiang Rai province. At community level, three variables were associated with recurrence of DF; size of the village (p=0.007), number of villagers (p=0.009), tribe (p=0.043) and distance to a hospital (p=0.003). Three variables were associated with DF at personal and family levels in multivariate model: children whose parents worked as daily employees, and government officers and traders were more likely to have DF 1.56 (95%CI=1.22–2.48) and 4.31 (95%CI=4.66–9.38) times greater than of those whose parents’ worked as agriculturists, respectively; children aged less than one year were 2.89 (95%CI=2.17–4.33) times more likely to have DF than those aged=6 and children who were under standard growth and over standard growth were more likely to have DF than those standard growth 1.61 (95%CI=1.18–2.53) and 7.33 (95%CI=4.39–10.37) times, respectively.

This is the original research article which was conducted in detecting the factors associated with recurrence of DHF in Northern Thailand.

The purpose of this paper is to understand the pattern and perception of alcohol drinking among the Lahu people in northern Thailand.

A qualitative method was used to elicit information on the patterns and perceptions of alcohol drinking amongst the Lahu tribespeople. Question guidelines had been developed from literature reviews and approved by three experts in the field of public health and alcohol studies. A total of 21 participants of different ages and sexes from 3 separate Lahu villages were invited to provide information. All interviews were taped and transcribed before analysis. A content analysis was used.

Lahu people begin alcohol consumption at an average of 12 years, with males usually beginning before females of the same age. Consuming alcohol is perceived to be a sign of adulthood and is also used as a means of gaining social acceptance from others in the community. Alcohol is consumed throughout the year with young and old, male and females, describing varied reasons for drinking. Income, parental behavior, and peer pressure contributes to the onset of alcohol drinking among young Lahu people. Several factors contributed to the use of alcohol among the Lahu people such as sex, age, occupation and income, peer pressure, taste and price as well as cultural adaptations amongst the farming community that play a significant role in the frequency of alcohol consumption amongst the Lahu community.

The results should support the development of peer education on the negative impact of alcohol use among the young people, and development of a community agreement on reducing excessive alcohol use in the Lahu community should be implemented.

Hand foot mouth disease (HFMD) is an emerging disease caused by Enterovirus. HFMD usually occurs in South-East Asian countries including Thailand. Thailand has been indicated as one of the countries having high epidemic rate in children less than five years of age, particularly in the northern regions. The paper aims to discuss this issue.

A qualitative method was used to extract information from 48 informants from two different areas; high and low epidemic areas of HFMD. Question guidelines were developed from literature review and viewed by three external experts in the field before use. Interviews took place in a private and confidential room. Each interview lasted approximately 50 minutes.

There are no policies regarding HFMD control in both high and low epidemic areas of HFMD. The staff at sub-district local government level did not have the necessary qualifications for HFMD control. Additionally, staff were not stable, and there was a lack of a disease control team. Antiseptics for cleaning day care centers (DCC) were not effective for disease control; most DCC use Dettol®, soap, dishwashing liquid, detergent and water for cleaning the environment. These antiseptics do not include chlorine making it ineffective in destroying the virus.

The sub-district local government should be concerned about HFMD control; the staff should have the necessary qualifications suitable for disease control. Standard and practical HFMD control guideline should be set up and used in DCC.

Chiang Rai is the northernmost province of Thailand. Municipal solid wastes (MSWs) was generated 430,828.2 ton/y in this area; however, only 24 percent of waste was properly disposed, and 43 percent of waste was properly managed. The purpose of this paper is to explore knowledge, attitudes and practices (KAP) of highland residents in order to provide a basis for the development of waste management in the study area.

A cross-sectional study was conducted in Mae Fah Luang district, Thailand, from November 2016 to January 2017. A random sample of 451 respondents constituted the study population. Data were gathered using a structured questionnaire. Pearson Correlation and χ² were applied to identify the association among variables.

Overall, 73 percent of respondents had high level of knowledge; 85 percent of respondents showed neutral attitude; and 59 percent of respondents performed moderate practice on MSW management. The results highlighted that age and education levels were statistically significant associated with KAP levels on MSW management at (p=0.05).

The respondents who have good knowledge also have a good level of practice; and those who have good attitude also have a good level of practice. Socio-demographic factors and suitable way to promote an effective MSW management should be considered.