Browsing by Author "Wiput Phoolcharoen"

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    The potential demand for an AIDS vaccine in Thailand
    (2001-06-15) Viroj Tangcharoensathien; Wiput Phoolcharoen; Siriwan Pitayarangsarit; Sukhontha Kongsin; Vijj Kasemsup; Sripen Tantivess; Chutima Suraratdecha; Thailand Health Systems Research Institute; Mahidol University; Sukhothai Thammatirat Open University
    The recent ongoing phase III clinical trial of a preventive vaccine in Thailand has prompted studies on potential demand for the vaccine among public, employers and households. This study aims to demonstrate the impact of HIV/AIDS, estimate the AIDS vaccine budget required and design the vaccination strategies for different population groups. The analysis is based on available secondary data and several assumptions on levels of secondary infections among various risk groups. Among 15 groups, we identified eight groups as potential vaccinees: Direct CSW, IDU in treatment, IDU out of treatment, male STD, transport workers, CSW indirect, conscripts and prisoners. The vaccine budget, excluding other operating expenditure, was estimated based on a single dose regimen ranging from 100 Baht (US$3) to 1000 Baht (US$29) per dose. A total of US$1.8-17.7 million is required for non-infected catch-up population and US$0.2-1.9 million for the maintenance population in the subsequent year. We foresee a relative inefficient and inequitable consumption of AIDS vaccine, which requires proper policy analysis and government interventions. Before vaccine adoption, strong preventive measures must be in place. AIDS vaccine could play an additional, not a substituting, role. A thorough understanding, a wide consultation with stakeholders and public debates are crucial steps for sound policy formulation. Copyright © 2001 Elsevier Science Ireland Ltd.
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    Prevalence and determinants of overweight and obesity in Thai adults: Results of the Second National Health Examination Survey
    (2004-06-01) Wichai Aekplakorn; Yongyuth Chaiyapong; Bruce Neal; Suwat Chariyalertsak; Chaiyos Kunanusont; Wiput Phoolcharoen; Paibul Suriyawongpaisal; Mahidol University; Chulalongkorn University; The University of Sydney; Chiang Mai University; United Nations Population Fund; Health Systems Research Institute
    To describe the prevalence of overweight and obesity and examine their relationship with sociodemographic factors in Thai adults. Using data from a cross-sectional survey, the National Health Examination Survey 11 (NHES11), the authors examined the prevalence of overweight (BMI > 25 kg/m2) and obesity (BMI ≥ 30 kg/m2) in 3,220 Thai adults aged 20-59 yr. Univariate analyses and Logistic regression models were used to examine the association of overweight and obesity with socio-demographic and behavioral risk factors. The overall age-adjusted prevalence of overweight and obesity were 28. 3% and 6.8% respectively, with a higher prevalence for women than for men (overweight: 33.9% vs 19.2% and obesity: 8.8% vs 3.5%). The prevalence of overweight and obesity was greater among older compared to younger people and among residents of urban (34.8% and 9.9%) compared to rural areas (26.4% and 5.9%). The prevalence of overweight and obesity varied by region in line with the level of economic development - Bangkok, Central, North, South and North-East. By using logistic regression analysis, overweight was associated with a number of characteristics as follows: age (per ten years increase) with adjusted Odds Ratio (OR) of 1.3; women 1.4; married 2.2; being a current smoker 0.4, and living in Bangkok and the central region 1.6 (compare to North-East). There was no clear difference in prevalence of overweight and obesity among education levels and type of occupation after controlling for other covariates. In conclusion, women of middle age, married, and living in Bangkok and the Central region, are at greater risk of overweight and obesity. Without effective lifestyle modification programs to curb these physiologic risk factors at population level, it is likely that related disease burden will ensue. Public health surveillance and intervention to modify the risk factors of excessive weight should be implemented.
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    A trial of shortened zidovudine regimens to prevent mother-to-child transmission of human immunodeficiency virus type 1
    (2000-10-05) Marc Lallemant; Gonzague Jourdain; Sophie Le Coeur; Kim Soyeon; Sporn Koetsawang; Anne Marie Comeau; Wiput Phoolcharoen; Max Essex; Kenneth McIntosh; Vicharn Vithayasai; IRD Institut de Recherche pour le Developpement; Harvard School of Public Health; INED Institut National d' Etudes Demographiques; Mahidol University; University of Massachusetts Medical School; Thailand Ministry of Public Health; Children's Hospital Boston; Chiang Mai University; PHPT
    Background: The optimal duration of zidovudine administration to prevent perinatal transmission of human immunodeficiency virus type 1 (HIV-1) should be determined to facilitate its use in areas where resources are limited. Methods: We conducted a randomized, double-blind equivalence trial of four regimens of zidovudine starting in the mother at 28 weeks' gestation, with 6 weeks of treatment in the infant (the long-long regimen), which is similar to protocol 076; zidovudine starting at 35 weeks' gestation, with 3 days of treatment in the infant (the short-short regimen); a long-short regimen; and a short-long regimen. The mothers received zidovudine orally during labor. The infants were fed formula and were tested for HIV DNA at 1, 45, 120, and 180 days. After the first interim analysis, the short-short regimen was stopped. Results: A total of 1437 women were enrolled. At the first interim analysis, the rates of HIV transmission were 4.1 percent for the long-long regimen and 10.5 percent for the short-short regimen (P=0.004); at this point the short-short regimen was stopped. For the entire study period, the transmission rates were 6.5 percent (95 percent confidence interval, 4.1 to 8.9 percent) for the long-long regimen, 4.7 percent (95 percent confidence interval, 2.4 to 7.0 percent) for the long-short regimen, and 8.6 percent (95 percent confidence interval, 5.6 to 11.6 percent) for the short-long regimen. The rate of in utero transmission was significantly higher with the two regimens with shorter maternal treatment (5.1 percent) than with the two with longer maternal treatment (1.6 percent). Conclusions: The short-short zidovudine regimen is inferior to the long-long regimen and leads to a higher rate of perinatal HIV transmission. The long-short, short-long, and long-long regimens had equivalent efficacy. However, the higher rate of in utero transmission with the short-long regimen suggests that longer treatment of the infant cannot substitute for longer treatment of the mother. (C) 2000, Massachusetts Medical Society.