The association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand: a cross-sectional study

Background: Pesticide toxicity is an important health problem in Thailand due to the intensive use of hazardous pesticides.  This study aimed to determine and discuss patterns of pesticide use, health literacy, pesticide use behaviors and whether there is an association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand. Methods: This work was carried out between May 2017 and July 2017 and 161 participants were enrolled. Participant questionnaires were completed during face-to-face interviews. Results: 161 sweet corn farmers (89.98%) were interviewed about patterns of chemical pesticide use. Two of the pesticides used in the pre-planting phase were moderately toxic: paraquat (used by 55.2% of farmers) and imidacloprid (used by 15.5% of farmers). In the pre-emergence phase, participants reported using two moderately toxic pesticides: alachlor (used by 48.8% of farmers) and chlorpyrifos (used by 2.4% of farmers). At the post-emergence phase, participants reported using six moderately toxic pesticides: chlorpyrifos (used by 60.7% of farmers), paraquat (used by 38.1% of farmers), imidacloprid (used by 7.2% of farmers), 2-4D (used by 3.6% of farmers), abamectin (used by 3.6% of farmers) and cypermethrin (used by 1.2% of farmers). Health literacy levels were moderate level (Mean score = 91.62, SD = ± 7.06) and pesticide use behaviors were low level (Mean score = 67.80, SD = ± 4.04). When examining the association between health literacy and pesticide use behaviors, we found that functional literacy was significantly associated with pesticide use behaviors. These findings suggest that health literacy, which includes self-management and decision-making skills, should be given greater attention as pesticide use behaviors were unsafe. Conclusion: It may be necessary to develop approaches to reduce pesticide use and promote health literacy, thereby protecting farmers, consumers, the environment (soil, water, and air) and ecosystems from pesticide-related hazards.

The association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand: a cross-sectional study

Background: Pesticide toxicity is an important health problem in Thailand due to the intensive use of hazardous pesticides.  This study aimed to determine and discuss patterns of pesticide use, health literacy, pesticide use behaviors and whether there is an association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district, Thailand. Methods: This work was carried out between May 2017-July 2017 and 161 participants were enrolled. Participant questionnaires were completed during face-to-face interviews. Results:  This study found the response rate was 98.98%. 161 farmers were interviewed about patterns of chemical pesticide use. Two of the pesticides used in the pre-planting phase were moderately toxic: paraquat (used by 55.2% of farmers) and imidacloprid (used by 15.5% of farmers). In the pre-emergence phase, participants reported using two moderately toxic pesticides: alachlor (used by 48.8% of farmers) and chlorpyrifos (used by 2.4% of farmers). At the post-emergence phase, participants reported using six moderately toxic pesticides: chlorpyrifos (used by 60.7% of farmers), paraquat (used by 38.1% of farmers), imidacloprid (used by 7.2% of farmers), 2-4D (used by 3.6% of farmers), abamectin (used by 3.6% of farmers) and cypermethrin (used by 1.2% of farmers). Health literacy levels were moderate level (Mean score = 91.62, SD = ± 7.06) and pesticide use behaviors were low level (Mean score = 67.80, SD = ± 4.04). When examining the association between health literacy and pesticide use behaviors, we found that functional literacy was significantly associated with pesticide use behaviors. This suggests that health literacy, which includes self-management and decision-making skills, should be given greater attention as pesticide use behaviors were unsafe. Conclusion: It may be necessary to develop approaches to reduce pesticide use and promote health literacy, thereby protecting farmers, consumers, the environment (soil, water, and air) and ecosystems from pesticide-related hazards.

Brief communication (Original). Effectiveness of influenza control using nonpharmaceutical interventions at primary schools in Nakhon Phanom Province, Northeast Thailand

Background: The world is entering the post-outbreak period of the 2009 A H1N1 strain of the influenza virus. The strain is expected to continue spreading, as seasonal influenza viruses do each year. The majority of children have relatively low immunity and engage in activities at school where opportunities abound for exposure to and spreading of diseases.

Objectives: We compared the effectiveness of influenza prevention by using non-pharmaceutical measures in primary schools.

Methods: This study was conducted at two medium-sized primary schools in Nakhon Phanom province, Thailand. Multistage sampling was used to select students from Grades 4 to 6. The study group consisted of 230 students from the 2 schools and the control group 224 students from the 2 schools. The research included (a) 8 h of instruction on influenza-like illnesses and their prevention integrated into health promotion and physical education classes and (b) building understanding among parents and in the community. Data were analyzed for frequencies, percentages, and multiple logistic regression.

Results: Non-pharmaceutical influenza interventions reduced the rate of influenza-like illnesses by 77% (AOR = 0.23, 95% CI: 0.15"0.36). Students who did not receive the influenza-like prevention and control training had a morbidity of 54.9%; whereas those who received the training had a morbidity of 23.5%. Overall, the group receiving the educational model saw a 57% reduction in its morbidity compared with the control group. The students in the intervention group who washed their hands for 20 seconds three or more times per day had a morbidity of 38.9%, which resulted in an overall reduction in morbidity of 36.4%. The morbidity rate of students who missed school because they were ill was 39.5%. When comparing training methods, the hand-washing group saw morbidity reduced by 34.7%, while simply receiving news and information from public health officials resulted in only a 29.2% reduction in morbidity. Overall, the group receiving the disease prevention and control training was able to reduce morbidity by 58.7%.

Conclusion: Influenza prevention education among students was integrated into the health education curriculum. Children were taught hand-washing and respiratory etiquette (i.e., covering the nose and face when sneezing, coughing, and nose-blowing). Cartoon media were used as visual teaching aids. The results from this program helped to decrease the number of cases of influenza-like illness and morbidity among students and families.

The Stop-Bang Questionnaire as a Screening Tool for Obstructive Sleep Apnea-Induced Hypertension in Asian Population

Obstructive sleep apnea (OSA) is a common public health issue. If left untreated, OSA may cause a large health economic burden from cardiovascular complications particularly stroke. The diagnosis of OSA can be made by polysomnography, but its availability is limited in the developing countries in Asia. STOP-BANG questionnaire is a good screening tool but may need some adjustment for Asian population. STOP-BANG stands for: Snoring history, Tired during the day, Observed stop breathing while sleep, High blood pressure, body mass index (BMI) more than 35 kg/m², Age more than 50 years, Neck circumference more than 40 cm and male Gender. We compared clinical features in STOP-BANG questionnaire between 42 OSA induced hypertension patients and 82 healthy control subjects in the Faculty of Medicine, Khon Kaen University, Thailand. The best cutoff point for the BMI and the neck circumference were 24.5 kg/m² and 36 cm, respectively. The sensitivity and specificity of the BMI cutoff point were 97.2% and 91.40, while those of the neck circumference were 94.7% and 82.9%. In conclusion, the appropriate cutoff points of BMI and neck circumference for Thai STOP-BANG questionnaire were 25 kg/m² and 36 cm.

Effects of an influenza prevention program using non-pharmaceutical prevention measures to improve the knowledge, attitudes and practices of elementary school students in Nakhon Phanom province, Thailand

We evaluated an influenza prevention educational program using educational media, e-books and cartoons conducted among students in grades 4 through 6. The course was 8 hours long. The study was conducted at 4 schools; 230 students at each school were in the experimental group and 224 students at each school were in the control group (no educational intervention). The data were analyzed using the Wilcoxon matched-pair signed-rank test. The students in the experimental group had significantly greater knowledge (p<0.001), attitudes (p<0.001) and practices (p<0.001) scores after the intervention. However, the control group also had significantly greater knowledge (p<0.001) and attitudes (p<0.001) scores but not practices scores (p = 0.326). Further studies are needed to determine the factors that influenced these differences.

An exploratory study on association between family relationship and relapse among methamphetamine users in Compulsory Treatment System of Khon Kaen and Yasothon Provinces

BACKGROUND

It was estimated that 3.5 million Thais have ever used "Yaba (methamphetamine)" at least once in their entire life. The Northeastern region had the highest number of Yaba users with a high relapse rate after treatment.

OBJECTIVE

The authors aimed to explore the association between relapse, among methamphetamine users in the Compulsory Treatment System of Khon Kaen and Yasothon Provinces, and family relationship as well as other contextual factors.

MATERIAL AND METHOD

An exploratory study was conducted from all cases of post-treatment methamphetamine users in the databases of Khon Kaen Drug Dependence Treatment Center and Yasothorn Provincial Probation Office during October 2007 and February 2008. Interviews and observations were done for data collection. Double data entry was applied. Pearson Chi-square, Fisher's exact test and odds ratio were used to assess the associations.

RESULTS

Sixty-five users were found (13 relapses and 52 abstainers). Family relationship revealed no significant association with relapse of the methamphetamine users. Other contextual factors, however, did. They were social acceptance [acceptance by community leader (p = 0.006), acceptance for working or studying (p = 0.049)], risky community situations [using Yaba of close friend, existence of Yaba users and Yaba trading in community (p = 0.014, p < 0.001 and p = 0.038 respectively)] and risky personal behaviors [ever selling or being a Yaba agent and drinking of alcohol to reduce Yaba desire (p = 0.012 and p = 0.013)].

CONCLUSION

Effect of family relationship on relapse among post-treatment methamphetamine users could not be demonstrated in the present study. But several contextual factors had significant relationship with the relapse.

Missed appointments at a tuberculosis clinic increased the risk of clinical treatment failure

We investigated the charts of 381 new smear-positive tuberculosis patients at Khon Kaen Medical School during 1997-2001 using World Health Organization definitions to evaluate associations among treatment success or failure (defaulted, failed, died, or not evaluated) and tuberculosis clinic contact, demographics and clinical characteristics of the patients. Multinomial logistic regression was used for three-category outcome analysis: treatment success, transferred-out and clinical treatment failure. The treatment success and clinical treatment failure rates were 34.1% and 34.4%, respectively. About 46.5% and 85.8% of patients missed appointments at the tuberculosis clinic in the treatment success and treatment failure groups, respectively. The results show that patients who were absent from the tuberculosis clinic were 5.95 times more likely to have clinical treatment failure than treatment success, having adjusted for the effect of transfering-out and the effect of the treatment regimen and the sputum conversion status (adjusted odds ratio = 5.95; 95% CI: 2.99 to 11.84). The review showed that absence from the tuberculosis clinic was an independent risk factor for clinical treatment failure. We recommended that all new smear-positive tuberculosis patients should be followed closely at a tuberculosis clinic.

The rapid village survey in tuberculosis control

SETTING

Khon Kaen Province, North-East Thailand.

OBJECTIVE

To develop a rapid and cheap method of surveying a population cluster (a village) to establish the prevalence of sputum-positive tuberculosis.

DESIGN

Based on previous experience a standardized 'rapid village survey' method was designed and tested. In this method a survey team of health workers is constituted and trained. Before and at the beginning of a visit to a village the population receives information about tuberculosis, and only individuals with chest symptoms are invited to report voluntarily to the survey team for examination. Active tracing of a previously compiled 'list of suspects and contacts' complements the identification of cases. The number of community members to be examined is thus much lower. A cluster sample of the provincial population was made (20,730 people in 40 villages). The population in each village was surveyed first by the Rapid Village Survey method, then, 1 week later, by the conventional method of examining every individual registered in each village.

RESULTS

In the rapid village survey 14 cases of sputum-positive tuberculosis were detected and in the conventional survey 15 cases.

CONCLUSION

The rapid method produces results comparable to the survey of the total sample population for less than half of the cost.

Rapid village survey to determine the size of the leprosy problem in Khon Kaen Province, Thailand

The rapid village survey (RVS) method has been developed as a simpler, less-expensive alternative to random sample surveys for determining the prevalence of leprosy and was compared with a total population survey (TVS). In the RVS, the cluster population receives clear information about the disease, and those with symptoms are invited to be examined by the survey team. A list of household contacts and suspects was made and those on the list were actively traced. The registered population was 20,815; 10 new patients were found among the 2034 people self-reporting in the RVS, 0 among the household contacts and suspects, and an additional 2 new patients in the TVS. There were 12 registered patients among the sample population. The prevalence rate found by the RVS was 1.06 per 1000(95% CI = 0.49-1.63) and in the TVS 1.16 per 1000 (95% CI = 0.5-1.77). The man-days and costs of an RVS are considerably less than those for a TVS. It was concluded that the RVS is a valid replacement for the TVS as conducted in Khon Kaen Province, Thailand. The RVS can be applied under low-endemic conditions and could be carried out by the general health staff.