Browsing by Author "Sawitri Assanangkornchai"

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    Author Correction: Women and other risk factors for chronic kidney disease of unknown etiology in Thailand: National Health Examination V Survey (Scientific Reports, (2021), 11, 1, (21366), 10.1038/s41598-021-00694-9)
    (2021-12-01) Wichai Aekplakorn; Suwat Chariyalertsak; Pattapong Kessomboon; Sawitri Assanangkornchai; Surasak Taneepanichskul; Nareemarn Neelapaichit; Anchalee Chittamma; Chagriya Kitiyakara; Ramathibodi Hospital; Chulalongkorn University; Faculty of Medicine, Khon Kaen University; Faculty of Medicine, Prince of Songkia University; Chiang Mai University
    The original version of this Article contained an error in Affiliation 6, which was incorrectly given as ‘Faculty of Medicine, Ramathibodi School of Nursing, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand’. The correct affiliation is listed below: Ramathibodi School of Nursing, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand The original Article has been corrected.
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    Increasing glycaemia is associated with a significant decline in HDL cholesterol in women with prediabetes in two national populations
    (2021-12-01) Chaiwat Washirasaksiri; Weerachai Srivanichakorn; Ian F. Godsland; Chayanis Kositamongkol; Suwat Chariyalertsak; Pattapong Kessomboon; Sawitri Assanangkornchai; Surasak Taneepanichskul; Nareemarn Neelapaichit; Pochamana Phisalprapa; Desmond G. Johnston; Nick S. Oliver; Wichai Aekplakorn; Ramathibodi Hospital; Siriraj Hospital; Chulalongkorn University; Faculty of Medicine, Khon Kaen University; Faculty of Medicine, Prince of Songkia University; Imperial College Faculty of Medicine; Faculty of Medicine Ramathibodi Hospital, Mahidol University; Chiang Mai University
    Internationally, studies have shown associations between lipids and glycemia; however, whether the link varies by gender and population has been rarely examined. We investigated relationships between glycemia and HDL- and Non-HDL-cholesterol and their modification by gender. We undertook a cross-sectional analysis from the National Health Examination Survey for Thailand (NHES-Thailand) and the Health Survey for England (HS-England) in adults aged 18–75 year. Glycaemia was assessed by FPG in Thailand and by HbA1c in the UK. In population- and gender-stratified analyses, the relationships between glycemia and lipids were explored. A total of 15,145 Thai and 3484 UK adults with blood measurement were included. The prevalences of prediabetes were: in NHES-Thailand, 16% (SE = 0.004), based on FPG (5.6 to < 7.0 mmol/L) and in HS-England, 19% (0.007) based on HbA1c (39 to < 48 mmol/mol). Increasingly abnormal glucose homeostasis was associated with increasing age, adiposity, SBP, proportion of antihypertensive and lipid-lowering agent use and with decreasing HDL-cholesterol. Independent of age, adiposity, smoking, alcohol, physical activity, and lipid and BP lowering drug use, increasing glycemia was associated with decreasing HDL-cholesterol specifically in women with prediabetes (NHES-Thailand, beta-coefficient − 0.07 (95% CI − 0.15, − 0.001) p = 0.04 and HS-England, − 0.03 (− 0.04, − 0.006) p = 0.01). In both populations, among those with prediabetes, increasing glycaemia is associated with an adverse, significant decline in HDL cholesterol, specifically in women. These adverse effects are apparent in widely-differing international populations.
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    Intervening alcohol marketing to reduce harmful alcohol use and lessons learned from the theory of changes: Case studies in Thailand
    (2021-11-01) Paibul Suriyawongpaisal; Sawitri Assanangkornchai; Udomsak Saengow; Ignacio J. Martinez Moyano; Roengrudee Patanavanich; Pongthep Wongwatcharapaiboon; Wichai Aekplakorn; Thanita Thongtan; Ramathibodi Hospital; Texas Tech University Health Sciences Center at Lubbock; The University of Chicago; Argonne National Laboratory; Walailak University; Prince of Songkla University; Nan Hospital
    Objectives: Globally, the burden of disease caused by alcohol use has been steadily increasing, including in Thailand. In this study, we aim to test the effectiveness of Anderson et al.‘s suggested three approaches to change the collective social norms, which comprise of: (1) providing information and an understanding about alcohol use behaviour, its causes and distribution; (2) focusing strategies on groups rather than individuals; and (3) strengthening supportive laws, regulations and approaches. Study design: We employed a mixed-methods approach. Evidence was gathered from literature review and in-depth interviews with key individuals who are responsible for community-based interventions to alcohol marketing strategies in Thailand. Methods: We chose to focus on two case studies in Nan and Surin provinces, where hospital-based longitudinal data (8 years) were available. Changes in casualties related to the harmful use of alcohol, resulting from interactions between community-based interventions and alcohol marketing during the time of annual festivals were investigated. We employed the theory of change (ToC) defined by Vogel to guide the data collection and analysis. We reviewed literature from online databases and grey literature to generate causal-loop diagrams. Results: We created a causal-loop diagram to describe the complexity of harmful alcohol use, its related factors, context, interventions and outcomes. Over the decade between 2006 and 2015, community-based strategies led to a substantial reduction of casualties (initially a 50% reduction, rising to an 80–90% reduction by the end of the study period) during the time of the festivals. Conclusions: The reduction in injuries and fatalities could be a result of the concerted actions, including legal sanctions of alcohol beverage sales and advertisement, and public education to raise awareness and impart knowledge of the harmful use of alcohol. The actions were organised by a coalition of civil society, health professionals, public authorities and community leaders using hospital-based data on the adverse effects of harmful alcohol use to mobilise political support at the provincial level. The availability of long-term financial support as a catalytic source of funds and the presence of a comprehensive alcohol control act enabled framing and mobilisation of local resources and political support.
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    Metabolic syndrome in Thai adolescents and associated factors: the Thai National Health Examination Survey V (NHES V)
    (2021-12-01) Sirinapa Siwarom; Wichai Aekplakorn; Kwanchai Pirojsakul; Witchuri Paksi; Pattapong Kessomboon; Nareemarn Neelapaichit; Suwat Chariyalertsak; Sawitri Assanangkornchai; Surasak Taneepanichskul; Chulalongkorn University; Khon Kaen University; Faculty of Medicine Ramathibodi Hospital, Mahidol University; Prince of Songkla University; Chiang Mai University
    Background: Presence of metabolic syndrome (MetS) in early life may influence cardiovascular outcome later in adulthood. There is limited data regarding MetS among Thai adolescents. This study aimed to estimate the prevalence of MetS and related factors in Thai adolescents. Methods: Data on MetS components of 1934 Thai adolescents aged 10–16 years were obtained from the 5th National Health Examination Survey. Age at first screen time exposure, duration of screen time, frequency of food intake and physical activities were collected from interviews. MetS was defined according to 3 definitions: International Diabetes Federation (IDF), Cook’s, and de Ferranti’s. Results: The prevalence of MetS was 4.1% by IDF, 8.0% by Cook’s, and 16.8% by de Ferranti’s definition. The overall prevalence was higher in male (19.0%) than female adolescents (15.3%). The most common MetS components composition among Thai adolescents was high waist circumference with high serum triglyceride and low HDL-cholesterol (40.0% for IDF, 22.6% for Cook’s and 43.5% for de Ferranti’s definition). Exposure to screen media during the first 2 years of life had a 1.3- fold increased odds of MetS by 1 out of 3 definitions (OR 1.30, 95% CI. 1.01–1.68). Duration of physical activity associated with decreased odds of MetS by Cook’s definition (OR 0.96, 95% CI. 0.92–0.99). Conclusions: The prevalence of MetS among Thai adolescents was higher than previously reported by other studies. Screen media exposure during the first 2 years of life should be discouraged and measures to promote physical activity among children and adolescents should be strengthen.
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    Socio-economic inequalities in the association between alcohol use disorder and depressive disorder among Thai adults: a population-based study
    (2020-12-01) Sawitri Assanangkornchai; Jiraluck Nontarak; Wichai Aekplakorn; Suwat Chariyalertsak; Pattapong Kessomboon; Surasak Taneepanichskul; Chulalongkorn University; Khon Kaen University; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Mahidol University; Prince of Songkla University; Chiang Mai University
    © 2020, The Author(s). Background: Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups. Methods: We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged > 20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0–7), hazardous drinking (score 8–15), and harmful-dependent drinking (score 16–40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels. Results: The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5, 10.3, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR = 8.68, 95% CI: 5.34, 14.11) and lowest (AOR = 7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR = 1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR = 16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR = 1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR = 8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR = 4.73, 95% CI: 3.31, 6.77). Conclusion: Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.
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    Stigmatizing attitudes toward people living with HIV among general adult Thai population: Results from the 5thThai National Health Examination Survey (NHES)
    (2017-11-01) Kriengkrai Srithanaviboonchai; Suwat Chariyalertsak; Jiraluck Nontarak; Sawitri Assanangkornchai; Pattapong Kessomboon; Panwadee Putwatana; Surasak Taneepanichskul; Wichai Aekplakorn; Chiang Mai University; National Health Examination Survey Office; Prince of Songkla University; Khon Kaen University; Mahidol University; Chulalongkorn University
    © 2017 Srithanaviboonchai et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Background: HIV-related stigma and discrimination is a significant driver of the HIV and AIDS epidemic. UNAIDS encourages all nations to monitor progress toward elimination of this problem. This study measured the level of stigmatizing attitudes toward people living with HIV (PLHIV) among Thai adults in the general population using recommended global tools. Methods: Data from the 5th National Health Examination Survey, conducted in 2014 were used. The survey utilized six questions recommended by the Global Stigma and Discrimination Indicator Working Group and was administered to participants aged 20–59 years old. All analyses were weighted to take into account of the probability of sampling the same-age Thai population. Factors related to a discriminatory attitude according to UNAIDS, defined as agreed to at least one of the two discriminatory issues, were evaluated using Chi square tested and multivariable logistic regression. Results: Of the 10,522 respondents, the most prevalent stigmatizing attitude was anticipated stigma (76.9%), followed by perceived stigma (69.2%), fear of HIV infection (57.0%), and social judgment (38.2%). Fifty-eight point six percent had discriminatory attitudes according to the UNAIDS global indicator. Independent predictors were being female (AOR = 1.21: 95% CI 1.14–1.29), aged 20–39 (AOR = 1.19: 95% CI 1.09–1.30) or 50–59 (AOR = 1.18: 95%CI 1.12–1.26), being Muslim (AOR = 2.03: 95%CI 1.55–2.66), earning < 10,000 Baht/month (AOR = 0.93: 95%CI 0.88–0.99), and living in the Northeast (AOR = 1.67: 95%CI 1.39–2.00) or in Bangkok (AOR = 1.73: 95%CI 1.45–2.07). Conclusions: More than half of the general adult Thai population had stigmatizing attitudes toward PLHIV. The study provided valuable baseline information which could be used as comparison for follow-up surveys with other countries. Interventions to improve Thai society’s knowledge and attitudes toward HIV/AIDS are urgently needed.
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    Universal coverage but unmet need: National and regional estimates of attrition across the diabetes care continuum in Thailand
    (2020-01-01) Lily D. Yan; Piya Hanvoravongchai; Wichai Aekplakorn; Suwat Chariyalertsak; Pattapong Kessomboon; Sawitri Assanangkornchai; Surasak Taneepanichskul; Nareemarn Neelapaichit; Andrew C. Stokes; Chulalongkorn University; Boston University School of Public Health; Khon Kaen University; Faculty of Medicine, Ramathibodi Hospital, Mahidol University; Prince of Songkla University; Boston Medical Center; Chiang Mai University
    BACKGROUND: Diabetes is a growing challenge in Thailand. Data to assess health system response to diabetes is scarce. We assessed what factors influence diabetes care cascade retention, under universal health coverage. METHODS: We conducted a cross-sectional analysis of the 2014 Thai National Health Examination Survey. Diabetes was defined as fasting plasma glucose ≥126mg/dL or on treatment. National and regional care cascades were constructed across screening, diagnosis, treatment, and control. Unmet need was defined as the total loss across cascade levels. Logistic regression was used to examine the demographic and healthcare factors associated with cascade attrition. FINDINGS: We included 15,663 individuals. Among Thai adults aged 20+ with diabetes, 67.0% (95% CI 60.9% to 73.1%) were screened, 34.0% (95% CI 30.6% to 37.2%) were diagnosed, 33.3% (95% CI 29.9% to 36.7%) were treated, and 26.0% (95% CI 22.9% to 29.1%) were controlled. Total unmet need was 74.0% (95% CI 70.9% to 77.1%), with regional variation ranging from 58.4% (95% CI 45.0% to 71.8%) in South to 78.0% (95% CI 73.0% to 83.0%) in Northeast. Multivariable models indicated older age (OR 1.76), males (OR 0.65), and a higher density of medical staff (OR 2.40) and health centers (OR 1.58) were significantly associated with being diagnosed among people with diabetes. Older age (OR 1.80) and higher geographical density of medical staff (OR 1.82) and health centers (OR 1.56) were significantly associated with being controlled. CONCLUSIONS: Substantial attrition in the diabetes care continuum was observed at diabetes screening and diagnosis, related to both individual and health system factors. Even with universal health insurance, Thailand still needs effective behavioral and structural interventions, especially in primary health care settings, to address unmet need in diabetes care for its population.
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    Women and other risk factors for chronic kidney disease of unknown etiology in Thailand: National Health Examination V Survey
    (2021-12-01) Wichai Aekplakorn; Suwat Chariyalertsak; Pattapong Kessomboon; Sawitri Assanangkornchai; Surasak Taneepanichskul; Nareemarn Neelapaichit; Anchalee Chittamma; Chagriya Kitiyakara; Ramathibodi Hospital; Chulalongkorn University; Faculty of Medicine, Khon Kaen University; Faculty of Medicine, Prince of Songkia University; Chiang Mai University
    There are limited data on chronic kidney disease of unknown etiology (CKDu) from Southeast Asia. Initially described in working age men, a common approach to detect CKDu that includes all adults has recently been proposed. We determined the prevalence, and risk factors for CKDu using data from a cross-sectional, nationally representative survey of the adult population of Thailand. We used a proxy for CKDu as age < 70 with impaired kidney function (eGFR < 60) in the absence of diabetes and hypertension (CKDu1) and heavy proteinuria (CKDu2). Prevalence estimates were probability-weighted for the Thai population. The associations between risk factors and CKDu or elderly subjects with eGFR < 60 without traditional causes were assessed by multivariable logistic regression. Of 17,329 subjects, the prevalence were: eGFR < 60, 5.3%; CKDu1 0.78%; CKDu2, 0.75%. CKDu differed by 4.3-folds between regions. Women, farmers/laborers, older age, gout, painkillers, rural area, and stones were independent risk factors for CKDu. Women, age, rural, gout, painkillers were significant risk factors for both CKDu and elderly subjects. These data collected using standardized methodology showed that the prevalence of CKDu in Thailand was low overall, although some regions had higher risk. Unlike other countries, Thai women had a two-fold higher risk of CKDu.