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Item Metadata only Stigma and discrimination-related experience of women living with HBV during pregnancy : a study in urban area of Shijiazhuang, Hebei province, China(Mahidol University. Mahidol University Library and Knowledge Center, 2009) Liu, Wei; Luechai SringernyuangPublication Open Access Accuracy of commercially available creactive protein rapid tests in the context of undifferentiated fevers in rural Laos(2016) Koukeo Phommasone; Thomas Althaus; Phonesavanh Souvanthong; Khansoudaphone Phakhounthong; Laxoy Soyvienvong; Phatthaphone Malapheth; Mayfong Mayxay; Pavlicek, Rebecca L.; Paris, Daniel H.; David Dance; Paul Newton; Yoel Lubell; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research Unit (MORU)Background: C-Reactive Protein (CRP) has been shown to be an accurate biomarker for discriminating bacterial from viral infections in febrile patients in Southeast Asia. Here we investigate the accuracy of existing rapid qualitative and semi... impact and cost-effectiveness at point of care is warranted.Publication Open Access Validation and factor structure of the Thai version of the EURO-D scale for depression among older psychiatric patients(2009) Tawanchai Jirapramukpitak; Niphon Darawuttimaprakorn; Sureeporn Punpuing; Abas, Melanie; Mahidol University. Institute for Population and Social Researchconsecutive psychiatric clinic attendees. A trained interviewer administered the Euro-D. We used receiver operating characteristic (ROC) analysis to assess the overall discriminability of the Euro-D scale and principal components factor analysis to assess its... construct validity. Results: The area under the ROC curve for the Euro-D with respect to major depressive episode was 0.78 [95% confidence interval (CI) 0.70-0.90] indicating moderately good discriminability. At a cut-point of 5/6 the sensitivity for majorPublication Open Access Migrant workers and social protection in ASEAN: moving towards a regional standard?(2012-07) Hall, Andy; Mahidol University. Institute for Population and Social ResearchThe number of migrants originating from ASEAN member states is estimated at 13.5 million, 39 percent (5.3 million) of whom are working in other ASEAN countries. An estimated 60% of the working population in these countries work in informal sectors of the economy that are not fully covered by labor laws, let alone social protection measures. In addition, nascent social protection systems in these countries provide little coverage in case of loss of worker income, and standards are generally poorly enforced. In this context, migrant social protection in ASEAN has rarely been explored. This paper considers global standards and themes regarding migrant social protection before outlining case studies of Indonesia, Philippines, Singapore and Thailand. The paper shows how migrants rarely access social protection in ASEAN and recommends regional action by ASEAN member states to holistically remedy this.Publication Open Access Parasite clearance rates in Upper Myanmar indicate a distinctive artemisinin resistance phenotype: a therapeutic efficacy study(2016) Tun, Kyaw Myo; Atthanee Jeeyapant; Mallika Imwong; Min Thein; Sai Soe Moe Aung; Hlaing, Tin Maung; Prayoon Yuentrakul; Cholrawee Promnarate; Mehul Dhorda; Woodrow, Charles J.; Dondorp, Arjen M.; Ashley, Elizabeth A.; Smithuis, Frank M.; White, Nicholas J.; Day, Nicholas P. J.; Mahidol University. Faculty of Tropical Medicine. Mahidol-Oxford Tropical Medicine Research UnitBackground: Artemisinin resistance in Plasmodium falciparum extends across Southeast Asia where it is associated with worsening partner drug resistance and a decline in the efficacy of frontline artemisinin-based combination therapy. Dihydroartemisinin-piperaquine (DP) is an essential component of preventive and curative treatment in the region, but its therapeutic efficacy has fallen in Cambodia. Methods: A prospective clinical and parasitological evaluation of DP was conducted at two sites in Upper Myanmar between August 2013 and December 2014, enrolling 116 patients with acute uncomplicated falciparum malaria. Patients received DP orally for 3 days together with primaquine 0.25 mg/kg on admission. Parasite clearance half-lives based on 6 hourly blood smears, and day 42 therapeutic responses were assessed as well as parasite K13 genotypes. Results: Median parasite clearance half-life was prolonged, and clearance half-life was greater than 5 h in 21 % of patients. Delayed parasite clearance was significantly associated with mutations in the propeller region of the parasite k13 gene. The k13 F446I mutation was found in 25.4 % of infections and was associated with a median clearance halflife of 4.7 h compared with 2.7 h for infections without k13 mutations (p < 0.001). There were no failures after 42 days of follow-up, although 18 % of patients had persistent parasitaemia on day 3. Conclusion: The dominant k13 mutation observed in Upper Myanmar, F446I, appears to be associated with an intermediate rate of parasite clearance compared to other common mutations described elsewhere in the Greater Mekong Subregion. Discerning this phenotype requires relatively detailed clearance measurements, highlighting the importance of methodology in assessing artemisinin resistance.Publication Open Access The relevance of longitudinal research for population and health(2008-01) Bencha Yoddumnern-Attig; เบญจา ยอดดำเนิน-แอตติกจ์; Guest, Philip; Varachai Thongthai; วรชัย ทองไทย; Sureeporn Punpuing; สุรีย์พร พันพึ่ง; Chanya Sethaput; จรรยา เศรษฐบุตร; Aree Jampaklay; อารี จำปากลาย; Rossarin Gray; รศรินทร์ เกรย์; Yupin Vorasiriamorn; ยุพิน วรสิริอมร; Boonlert Leoprapai; Mahidol University. Institute for Population and Social ResearchLongitudinal research is the term coined to differentiate the methodology and utility of this type of research with that of cross-sectional research. It is a necessary tool for studying social change and dynamic behavior due to its ability to track individuals over time to assess change. A prime principle of longitudinal studies is to link individual data across time. The need for and utility of longitudinal research are extremely relevant today. The growing diversity of changes led by globalization, population trends and epidemiological transitions force researchers to better understand and grasp the nature and processes of change associated with social and behavioral dynamics. This paper synthesizes the ways in which longitudinal research has been a valuable tool for analyzing changing trends in population and health and the causal factors contributing to these changes, with special attention to its use in the Asia and Pacific Region. The discussion centers on three main aspects, beginning with an overview of longitudinal research, its development and changing needs, its distinctive features, and its relevance to population and health research. The presentation continues with a review of the utility of longitudinal studies in population and health research, followed by an assessment of the prospects and challenges for longitudinal studies.Publication Open Access Factors associated with quality of life among the elderly in Baglung District, Nepal(2017) Pradeep GC; Sariyamon Tiraphat; Jiraporn Chompikul; ประดีพ จีซี; ศริยามน ติรพัฒน์; จิราพร ชมพิกุล; Mahidol University. ASEAN Institute for Health DevelopmentThis community based cross-sectional study was conducted to investigate the factors associated with quality of life among the elderly in Baglung district, Nepal. The sample size was 403 elderly selected by multi-stage cluster sampling from Baglung district. The data were collected by face to face interview using structured questionnaires. The outcome variable was the World Health Organization Quality of Life (WHOQOL-BREF), while independent variables included socio-demographic factors and neighbourhood social and environmental factors. Descriptive statistics were used to describe the characteristics of the sample. Chi-square test and multiple logistic regressions were used to determine the association between independent variables and quality of life among the elderly. The finding showed that approximately half of the elderly (51.1%) had high quality of life. Factors associated with the quality of life included age, gender, marital status, religious, family structure, social capital, neighbourhood aesthetic and crime. After adjusting other factors, high quality of life was detected among the elderly who were perceived high neighbourhood social capital (Adj OR = 2.52, 95% CI = 1.48-4.29), perceived high neighbourhood aesthetic (Adj OR = 3.16, 95% CI = 1.91-5.23) and perceived low crime (Adj OR = 3.94, 95% CI = 2.31-6.72) in neighbourhood comparing to their counterparts. From the results of this study, interventions that can promote active aging, such as designing of age-friendly public spaces and pleasant social environments should be considered. Moreover, policy to improve quality of life towards the elderly should be seriously implemented.Publication Open Access Clinically unapparent infantile thiamin deficiency in Vientiane, Laos.(2011-02-22) Khounnorath, Sengmanivong; Chamberlain, Karen; Taylor, Ann M.; Soukaloun, Douangdao; Mayxay, Mayfong; Lee, Sue J.; Phengdy, Bounthom; Luangxay, Khonsavanh; Sisouk, Kongkham; Soumphonphakdy, Bandit; Latsavong, Khaysy; Akkhavong, Kongsin; White, Nicholas J.; Newton, Paul N.; Newton, Paul N.; Mahidol University. Faculty of TropicalMedicine. Mahidol-Oxford Tropical Medicine Research Unit.BACKGROUND: Beriberi occurs in Vientiane, Lao PDR, among breastfed infants. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to other illnesses. Thiamin treatment could improve outcome. METHODOLOGY/PRINCIPAL FINDINGS: A cohort of 778 sick infants admitted during one year without clinical evidence of beriberi were studied prospectively and erythrocyte transketolase assays (ETK) performed. Biochemical thiamin deficiency was defined both in terms of the activation coefficient (α>31%) and basal ETK activity <0.59 micromoles/min/gHb. Of the 778 infants, median (range) age was 5 (0-12) months, 79.2% were breastfed, 5.1% had α>31% and 13.4 % basal ETK<0.59 micromoles/min/gHb. Infants≥2 months old had a higher frequency of biochemical markers of thiamin deficiency. Mortality was 5.5% but, among infants ≥2 months old, mortality was higher in those with basal ETK<0.59 micromoles/min/gHb (3/47, 6.4%) than in those with basal ETK≥0.59 micromoles/min/gHb (1/146, 0.7%) (P=0.045, relative risk=9.32 (95%CI 0.99 to 87.5)). Multivariate regression analysis indicated that infant age≥2 months and fewer maternal years of schooling were independently associated with infant basal ETK<0.59 micromoles/min/gHb. CONCLUSIONS/SIGNIFICANCE: Clinically unapparent thiamin deficiency is common among sick infants (≥2 months old) admitted to hospital in Vientiane. This may contribute to mortality and a low clinical threshold for providing thiamin to sick infants may be needed.Publication Open Access Prognostic factors of all-cause mortalities in continuous ambulatory peritoneal dialysis: a cohort study(2013) Phisitt Vejakama; Ammarin Thakkinstian; Atiporn Ingsathit; Prateep Dhanakijcharoen; Attia, John; Mahidol University. Faculty of Medicine Ramathibodi Hospital. Section for Clinical Epidemiology and BiostatisticsBackground: The role of small solute clearance on mortalities in patients with CAPD has been controversial. We therefore conducted a study with 3 years' follow up in adult patients who participated in the CAPD-first policy. Methods: There were 11,523 patients with end-stage renal disease who participated in the CAPD-first policy between 2008 and 2011. Among them, 1,177 patients were included in the retrospective cohort study. A receiver operating characteristic curve was applied to calibrate the cutoffs of tKt/V, rKt/V and tCrcl. Kaplan-Meier and Cox-regression models with time varying covariates were applied to estimate overall death rate, probability of death and prognosis, respectively. Results: The cutoffs of rKt/V and tKt/V were 0.25 and 1.75, respectively. The Cox regression suggested that the higher these clearance parameters, the lower the risks of death after adjusting for covariables. The risks of death for those above these cutoffs were 57% (HR = 0.43, 95% CI: 0.31, 0.60) and 29% (HR = 0.71, 95% CI: 0.52, 0.98) lower for rKt/V and tKt/V, respectively. Age, serum albumin, hemoglobin, systolic blood pressure, and ultra-filtration volume significantly affected the mortality outcome. Conclusions: Our study suggested that the cutoffs of 0.25 and 1.75 for rKt/V and tKt/V might be associated with mortality in CAPD patients. A minimum tKt/V of 1.75 should be targeted, but increased dialysis dosage to achieve tKt/V > 2.19 adds no further benefit. Serum albumin, hemoglobin, SBP, and UF volume are also associated with mortality. However, our study may face with selection and other unobserved confounders, so further randomized controlled trials are required to confirm these cutoffs.Publication Open Access Chronic hepatitis B prognostic markers other than pre-treatment viral load predicted composite treatment outcome(2013-07-15) Aung, Myo Nyein; Wattana Leowattana; วัฒนา เลี้ยววัฒนา; Win, Khine Nwe; Noppadon Tangpukdee; นพดล ตั้งภักดี; Sant Muangnoicharoen; สัณฑ์ ม่วงน้อยเจริญ; Wattana Leowattana; Mahidol University. Faculty of Tropical Medicine. Department of Clinical Tropical Medicine.INTRODUCTION: Chronic hepatitis B (CHB) is a globally common infectious disease. Its clinical course is complicated. In Southeast Asia, nucleos(t)ide analogues (NA) are commonly used drugs for CHB treatment. Composite treatment outcome has often been used in CHB clinical practice, but rarely predicted epidemiologically. This study aimed to compare the composite treatment outcome between CHB patients with low and high treatment-naïve viral load, and to identify its predictors METHODOLOGY: This retrospective cohort study followed up 95 CHB patients on NA treatment for a year. Composite treatment outcome was defined as undetectable HBV DNA level, ALT normalization and, HBeAg clearance in the case of HBeAg-positive patients. Multinomial logistic regression analysis was applied to analyze the significant treatment response predictors. RESULTS: Complete composite treatment outcome was achieved by 52% of CHB patients with an initial viral load < 6.5 log 10 copies /ml, but 31% of those had an initial viral load ≥ log 6.5 log 10 copies /ml. Outcome was predicted by HBeAg negativity (adjusted relative risk ratio, aRRR = 11.1, 95 % confidence interval, CI 3-41.3) and ALT normalization within the sixth month of therapy (aRRR = 6.7, CI 1.8-24.9). An elevation of ALT to more than 1.5 times the normal value (40 IU/ml) can lead to an incomplete response on NA therapy (aRRR = 6.2, CI 1.5-26.6.) CONCLUSION: Routine clinical markers other than pre-treatment viral load predicted composite CHB outcome on NA Therapy.